Department of Orthopaedic Surgery, Nepal Medical College, P.O. Box 13344, Jorpati, Kathmandu, Nepal.
Int Orthop. 2009 Dec;33(6):1637-40. doi: 10.1007/s00264-008-0704-y. Epub 2009 Jan 10.
This article summarises a prospective study to evaluate the long-term results produced by interosseous transfer of the tibialis posterior tendon for the correction of foot drop due to leprosy neuritis. The study was carried out in 120 feet in 69 patients. All patients had closed elongation of the tendo Achillis (ETA) before transfer of the bifurcated tibialis posterior tendon through the interosseous route to the tendons of tibialis anterior and peroneous tertius or brevis over the dorsum of feet. At final follow-up of average 24 months, all the patients with ETA had a significantly greater range of active dorsiflexion of more than 10 degrees above 90 degrees, which was not merely from the tenodesing effect. The results, in terms of improvement in gait and prevention of trophic changes, remained satisfactory. An interosseous route is preferred with split attachment to the tibialis anterior and to the peroneus brevis or tertius tendons.
本文总结了一项前瞻性研究，评估了通过骨间转移胫后肌腱治疗麻风性神经炎所致足下垂的长期效果。该研究纳入了 69 例患者的 120 只足。所有患者在转移分叉的胫后肌腱之前均有跟腱短缩（ETA），该肌腱通过骨间途径转移至胫骨前肌和外展肌短肌或第三肌的肌腱，位于足部背侧。在平均 24 个月的最终随访中，所有 ETA 的患者的主动背屈范围都显著增加了 10 度以上，达到 90 度以上，这不仅仅是由于肌腱固定的效果。在步态改善和预防营养性变化方面，结果仍然令人满意。骨间入路是首选，可将分叉附着于胫骨前肌和外展肌短肌或第三肌的肌腱。
