Movahedi Yeganeh Mohsen
Orthopedic Foot & Ankle Surgeon, Milad Hospital, Tehran, Iran
Foot Ankle Int. 2016 Jun;37(6):665-9. doi: 10.1177/1071100716629779. Epub 2016 Feb 9.
Anterior transfer of posterior tibial tendon (PTT) is the most common technique to correct foot drop in patients with common peroneal nerve palsy. It does not address the loss of toe extension or "toe drop." This may affect the gait pattern, and patients may not tolerate it. Described here is a technique that addresses toe drop associated with common peroneal nerve palsy.
A new technique of tendon transfer using the PTT, flexor hallucis longus (FHL) tendon, and flexor digitorum longus (FDL) tendon was performed on 15 patients (13 males and 2 females) with complete common peroneal nerve palsy from 2009 to 2013. Minimum follow-up was 12 months (range, 12-50 months). The mean age was 37 years (range, 20-52 years).
Based on the evaluation criteria of Carayon et al, the postoperative results for foot drop correction were excellent in 9 (60%), good in 5 (33%), and moderate in 1 (7%), and the mean active range of motion of the ankle was 46 degrees. Postoperative extension evaluation of the toes was excellent in 7 (47%), good in 5 (33%), and moderate in 3 (20%).
Releasing and transferring of FDL and FHL to the toe extensors along with the anterior transfer of the PTT neutralized the deforming forces and allowed for active toe extension while strengthening ankle dorsiflexion. Movahedi Tendon Transfer was a reliable method to achieve a balanced foot and toe dorsiflexion for complete common peroneal nerve palsy.
Level IV, retrospective case series.
胫后肌腱（PTT）前移是矫正腓总神经麻痹患者足下垂最常用的技术。但该技术无法解决趾背伸功能丧失或“趾下垂”问题。这可能会影响步态模式，患者可能难以耐受。本文介绍一种解决与腓总神经麻痹相关的趾下垂的技术。
2009年至2013年，对15例（男13例，女2例）完全性腓总神经麻痹患者采用一种新的肌腱转移技术，该技术使用PTT、拇长屈肌腱（FHL）和趾长屈肌腱（FDL）。最短随访时间为12个月（范围12 - 50个月）。平均年龄为37岁（范围20 - 52岁）。
根据Carayon等人的评估标准，足下垂矫正术后结果为优9例（60%），良5例（33%），中1例（7%），踝关节平均主动活动范围为46度。术后趾背伸功能评估为优7例（47%），良5例（33%），中3例（20%）。
将FDL和FHL松解并转移至趾背伸肌，同时进行PTT前移，可抵消致畸形力，实现趾主动背伸，同时增强踝关节背屈。Movahedi肌腱转移术是一种可靠的方法，可使完全性腓总神经麻痹患者足部和趾部实现平衡背屈。
IV级，回顾性病例系列。
