J Am Podiatr Med Assoc. 2021 Dec 15;111(6). doi: 10.7547/20-205.
Drop foot is a crippling condition that often requires surgical intervention to restore functional dorsiflexion. Although transfer of the posterior tibial (PT) tendon has been well described for the treatment of drop foot, there is no consensus on whether tendon transfers affecting the ankle joint sufficiently restore functional status for daily activities. In addition, most studies have focused on drop foot caused by peripheral nerve disorders. The purpose of this study was to evaluate the functional outcomes and patient satisfaction following PT tendon transfer for the correction of drop foot resulting from both peripheral and central neurologic causes.
Patients with drop foot who underwent a PT tendon transfer were followed for a minimum of 1 year and investigated retrospectively. Outcome measures included the American Orthopaedic Foot & Ankle Society ankle and hindfoot scoring system, a patient satisfaction questionnaire, postoperative ankle range of motion, and postoperative ambulatory status.
We evaluated 15 feet in 14 patients at a median follow-up of 50 months. The median postoperative American Orthopaedic Foot & Ankle Society ankle and hindfoot score was 85.0. Thirteen patients (92.9%) reported that they would undergo the procedure again. The median postoperative passive ankle dorsiflexion was 5.0°, and the median postoperative passive ankle plantarflexion was 30.0°. Thirteen patients (92.9%) were able to ambulate postoperatively. Ten (71.4%) ambulated without the use of an ankle-foot orthosis (AFO), and three (21.4%) ambulated with the use of an AFO. Overall, orthoses were able to be discontinued in 73.3% of the cases.
Our results suggest that the PT tendon transfer is an effective procedure for the treatment of drop foot that can improve the patient's functional status and ability to ambulate. The majority of patients were able to discontinue the use of their AFO postoperatively.
足下垂是一种致残性疾病，通常需要手术干预来恢复功能性背屈。尽管后胫（PT）肌腱转移已被广泛用于治疗足下垂，但对于影响踝关节的肌腱转移是否足以恢复日常活动的功能状态，尚无共识。此外，大多数研究都集中在外周神经疾病引起的足下垂上。本研究旨在评估 PT 肌腱转移治疗由周围和中枢神经原因引起的足下垂的功能结果和患者满意度。
对接受 PT 肌腱转移的足下垂患者进行了至少 1 年的随访，并进行了回顾性研究。评估指标包括美国矫形足踝协会踝关节和后足评分系统、患者满意度问卷、术后踝关节活动范围和术后步行状态。
我们在中位随访 50 个月时评估了 14 名患者的 15 只脚。术后美国矫形足踝协会踝关节和后足评分中位数为 85.0。13 名患者（92.9%）表示他们会再次接受该手术。术后被动踝关节背屈中位数为 5.0°，术后被动踝关节跖屈中位数为 30.0°。13 名患者（92.9%）术后可步行。10 名（71.4%）患者无需使用踝足矫形器（AFO）即可行走，3 名（21.4%）患者使用 AFO 行走。总体而言，73.3%的病例可以停止使用矫形器。
我们的结果表明，PT 肌腱转移是治疗足下垂的有效方法，可以改善患者的功能状态和步行能力。大多数患者术后能够停止使用 AFO。
