Saaiq M. Presentation and management outcome of foot drop with tibialis posterior tendon transfer. World J Orthop 2024; 15(11): 1047-1055 [DOI: 10.5312/wjo.v15.i11.1047]
Corresponding Author of This Article
Muhammad Saaiq, Assistant Professor, Department of Plastic Surgery, Consultant Plastic Surgeon and Head of Plastic Surgery Department, National Institute of Rehabilitation Medicine, Street No. 9, G-8/2, Islamabad 44000, Pakistan. muhammadsaaiq5@gmail.com
Research Domain of This Article
Surgery
Article-Type of This Article
Observational Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Orthop. Nov 18, 2024; 15(11): 1047-1055 Published online Nov 18, 2024. doi: 10.5312/wjo.v15.i11.1047
Presentation and management outcome of foot drop with tibialis posterior tendon transfer
Muhammad Saaiq
Muhammad Saaiq, Department of Plastic Surgery, Consultant Plastic Surgeon and Head of Plastic Surgery Department, National Institute of Rehabilitation Medicine, Islamabad 44000, Pakistan
Author contributions: Saaiq M designed the study, wrote the manuscript, performed data collection, analyses and approval of the manuscript; Saaiq M is responsible for final content of the manuscript.
Institutional review board statement: The study followed the ethical protocols of Helsinki’s Declaration, 2013 revision. Anonymity of the participants was ensured.
Informed consent statement: Informed consents were taken from the patients for inclusion in the study as well as including their photographs in the study.
Conflict-of-interest statement: All the authors report having no relevant conflicts of interest for this article.
Data sharing statement: No additional data are available as consent was not obtained from patients for sharing their data. Anonymity was guaranteed.
STROBE statement: The authors have read the STROBE Statement-checklist of items, and the manuscript was prepared and revised according to the STROBE Statement-checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Muhammad Saaiq, Assistant Professor, Department of Plastic Surgery, Consultant Plastic Surgeon and Head of Plastic Surgery Department, National Institute of Rehabilitation Medicine, Street No. 9, G-8/2, Islamabad 44000, Pakistan. muhammadsaaiq5@gmail.com
Received: August 3, 2024 Revised: September 26, 2024 Accepted: October 23, 2024 Published online: November 18, 2024 Processing time: 104 Days and 1.4 Hours
Abstract
BACKGROUND
Foot drop causes considerable disability. The ankle-dorsiflexion is either weak or lost completely. Additionally, the ankle eversion and toe extensions are also impaired. This results in a high steppage gait while walking. Overall, the gait is awkward; there is greater energy consumption; increased proneness to sustain injury of the forefoot; and more frequent falling during walking.
AIM
To document the clinical and epidemiological profile of foot drop patients in our population and evaluate the outcome of tibialis posterior (TP) tendon transfer for restoring the lost dorsiflexion in foot drop.
METHODS
The study was carried out at the National Institute of Rehabilitation Medicine in Islamabad over a period of 7 years. It included patients of all sexes and ages who presented with foot drop and had no contraindications for the procedure of TP tendon transfer. Exclusion criteria were patients who had contraindications for the operation. For instance, paralyzed posterior leg compartment muscles, Achilles tendon contracture, stiff ankle or toes, unstable ankle joint, weak gastrocnemius and scarred skin spanning over the route of planned tendon transfer. Also, patients who had the foot drop as a result of disc prolapses or brain diseases were excluded. Convenience sampling technique was used. The circum-tibial route of TP tendon transfer was employed.
RESULTS
Out of 37 patients, 26 (70.27%) were males whereas 11 (29.72%) were females. The mean age was 22.59 ± 8.19 years. Among the underlying causes of foot drop, road traffic accidents constituted the most common cause, found among 20 (54.05%) patients. The share of complications included wound infections in 3 (8.10%) patients and hypertrophic scars in 2 (5.40%) patients. At 1-year postoperative follow-up visits, the outcome was excellent in 8 (21.62%), good in 20 (54.05%) and moderate in 9 (24.31%).
CONCLUSION
The majority of cases of foot drop resulted from road traffic accidents that directly involved the common peroneal nerve. TP tendon transfer through the circumtibial route was found to be an easily executed effective operation which restored good dorsiflexion of the ankle among the majority of patients.
Core Tip: This study found that foot drop most commonly resulted from road traffic accidents and most often presented as isolated injury to the common peroneal nerve. The tibialis posterior tendon transfer through the circumtibial route was found to be technically easy and quick to execute. It resulted in restoring good dorsiflexion of the ankle among the majority of foot drop patients.
