Yeganeh Ali, Motaghi Arash, Shahhoseini Gholamreza, Farahini Hosein
MD, Assistant Professor of Orthopedics, Iran University of Medical Sciences, Tehran, Iran.
MD, Orthopedic surgeon, Assistant Professor of Hamedan University of Medical Sciences, Hamedan, Iran.
Med J Islam Repub Iran. 2013 Nov;27(4):163-7.
The transfer of the tibialis posterior tendon to the dorsum of foot can restore the function of theparalyzed dorsiflexor muscles of the foot and ankle. In order to reduce the wound complication in the insertionsite of tendon to bone by a plantar knop we used a new method of fixation by an absorbable screw inserted dorsally.
we performed this operation on 15 patients in a 3 years period. All patients had drop foot deformitydue to irreversible lesions of the peroneal nerve. The inclusion criteria was the peroneal nerve palsy that wasnot improved after 18 months even by using nerve releasing or nerve repairing. All patients were evaluatedafter 6 months for ankle function and wound complications.
Of 15 patients one was excluded from study. At 6 month ten patients got excellent score (66%) and 4good score (26%) further ankle function. There was no wound complication at insertion site.
This simple modification for insertion site fixation had good result in restoring ankle functionwhiles eliminated the possibility of plantar pressure sores caused by fixation knop.
胫后肌腱转移至足背可恢复足踝部麻痹的背屈肌功能。为减少经足底骨突进行肌腱骨插入部位的伤口并发症，我们采用了一种经背侧插入可吸收螺钉的新固定方法。
在3年期间，我们对15例患者实施了该手术。所有患者均因腓总神经不可逆损伤导致足下垂畸形。纳入标准为即使采用神经松解或神经修复，腓总神经麻痹18个月后仍未改善。所有患者在6个月后接受踝关节功能和伤口并发症评估。
15例患者中有1例被排除在研究之外。6个月时，10例患者踝关节功能评分优秀（66%），4例评分良好（26%）。插入部位无伤口并发症。
这种对插入部位固定的简单改良在恢复踝关节功能方面效果良好，同时消除了固定骨突导致足底压疮的可能性。
