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J Reconstr Microsurg 2009; 25(3): 157-164
DOI: 10.1055/s-0028-1103502
© Thieme Medical Publishers

Tibialis Posterior Tendon Transfer for Persistent Drop Foot after Peroneal Nerve Repair

Türker Özkan1 , Serdar Tuncer2 , Kahraman Ozturk3 , Atakan Aydin1 , Safiye Ozkan1
  • 1Department of Plastic, Reconstructive and Aesthetic Surgery, Hand Surgery Division, Istanbul University, Istanbul Medical Faculty, İstanbul, Turkey
  • 2Department of Plastic and Reconstructive Surgery, Medical Faculty, Istanbul Bilim University, İstanbul, Turkey
  • 3Orthopedics Department, Vakıf Gureba Training and Research Hospital, İstanbul, Turkey
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Publication History

Publication Date:
26 November 2008 (online)

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ABSTRACT

Despite advances in the surgical treatment of peroneal nerve injuries, a significant fraction of patients do not recover adequately. Among 35 patients who had previous repair of the peroneal nerve, 19 had permanent drop foot, and 16 of these patients underwent tibialis posterior (TP) tendon transfer. Mean duration of paralysis was 26.7 (range, 7 to 192) months. TP tendon was carried to the anterior compartment via the circumtibial route, and then attached to the tibialis anterior, extensor hallucis longus, extensor digitorum communis, and peroneus tertius tendons using tendon-tendon anastomosis. All patients except for one achieved active dorsiflexion to or beyond neutral. Mean preoperative drop foot angle increased from −33.8 degrees to + 9.7 degrees. According to the Stanmore system, the results were excellent in 10 patients (62.5%), good in 4 (25.0%), fair in 1 (6.2%), and poor in 1 (6.2%). The average Stanmore score was 85, which corresponded to an excellent result. We believe that the TP tendon transfer is a straightforward and reliable solution in the treatment of drop foot.

KEYWORDS

Peroneal nerve palsy - drop foot - tibialis posterior - tendon transfer

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Prof. Dr. Türker Özkan

Sezai Selek Sokak, Akil Apt. 2/2, D:5, Nişantaşı-34367

İstanbul, Turkey

Email: turker.ozkan@istanbul.edu.tr