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Tendon transfers for drop foot correction: long-term results including quality of life assessment, and dynamometric and pedobarographic measurements.
Arch Orthop Trauma Surg. 2011 Jul; 131(7):903-10.AO

Abstract

BACKGROUND

Drop foot deformity is a common problem with severe restrictions in quality of life and impairment of daily activities. A technique of posterior tibial tendon transfer through the interosseus membrane and fixation to the anterior tibial and the long peroneal tendon "Bridle procedure" (stirrup-plasty) offers a physiological alternative to surgical correction.

METHODS

Data of 53 consecutive patients treated by stirrup-plasty were acquired from patient's charts; 31 were interviewed with standardized questionnaires; 20 were examined physically; 19 received pedobarography, and 8 underwent dynamometric muscle function tests. Follow-up time averaged 6.5 years.

RESULTS

The mean range of motion (ROM) in the ankle joint was 8° dorsiflexion and 15° plantar flexion. Most patients achieved plantigrade foot position and the majority developed gait without orthotic devices. As expected, maximum dorsiflexion torque averaged a third of the non-operated leg, according to reduced muscle diameter and strength of the transferred muscle. Pressure distribution of the sole during gait was not relevantly altered by the tendon transfer compared to the non-operated leg. Most patients were satisfied with the operative results and reported a significant increase in quality of life.

CONCLUSIONS

Fusion of the transposed posterior tibial, anterior tibial and the peroneus longus tendon prevents drop foot deformity sufficiently. The stirrup mechanism, in combination with tenodesis of the toe extensors, provides a balanced foot and avoids equinovarus and cavus deformity without immobilizing the ankle joint. Improvements in quality of life parameters justify the risk of the operative procedure for the patient.

Authors+Show Affiliations

Department of Plastic Surgery, Burn Center, Hand Center, Sarcoma Reference Center, BG-University Hospital Bergmannsheil, Ruhr-University Bochum, Buerkle-de-la-Camp-Platz 1, 44789 Bochum, Germany. hans-ulrich.steinau@bergmannsheil.deNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

21246379

Citation

Steinau, Hans-Ulrich, et al. "Tendon Transfers for Drop Foot Correction: Long-term Results Including Quality of Life Assessment, and Dynamometric and Pedobarographic Measurements." Archives of Orthopaedic and Trauma Surgery, vol. 131, no. 7, 2011, pp. 903-10.
Steinau HU, Tofaute A, Huellmann K, et al. Tendon transfers for drop foot correction: long-term results including quality of life assessment, and dynamometric and pedobarographic measurements. Arch Orthop Trauma Surg. 2011;131(7):903-10.
Steinau, H. U., Tofaute, A., Huellmann, K., Goertz, O., Lehnhardt, M., Kammler, J., Steinstraesser, L., & Daigeler, A. (2011). Tendon transfers for drop foot correction: long-term results including quality of life assessment, and dynamometric and pedobarographic measurements. Archives of Orthopaedic and Trauma Surgery, 131(7), 903-10. https://doi.org/10.1007/s00402-010-1231-z
Steinau HU, et al. Tendon Transfers for Drop Foot Correction: Long-term Results Including Quality of Life Assessment, and Dynamometric and Pedobarographic Measurements. Arch Orthop Trauma Surg. 2011;131(7):903-10. PubMed PMID: 21246379.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Tendon transfers for drop foot correction: long-term results including quality of life assessment, and dynamometric and pedobarographic measurements. AU - Steinau,Hans-Ulrich, AU - Tofaute,Alexandra, AU - Huellmann,Kathrin, AU - Goertz,Ole, AU - Lehnhardt,Marcus, AU - Kammler,Jessica, AU - Steinstraesser,Lars, AU - Daigeler,Adrien, Y1 - 2011/01/19/ PY - 2010/08/04/received PY - 2011/1/20/entrez PY - 2011/1/20/pubmed PY - 2011/10/26/medline SP - 903 EP - 10 JF - Archives of orthopaedic and trauma surgery JO - Arch Orthop Trauma Surg VL - 131 IS - 7 N2 - BACKGROUND: Drop foot deformity is a common problem with severe restrictions in quality of life and impairment of daily activities. A technique of posterior tibial tendon transfer through the interosseus membrane and fixation to the anterior tibial and the long peroneal tendon "Bridle procedure" (stirrup-plasty) offers a physiological alternative to surgical correction. METHODS: Data of 53 consecutive patients treated by stirrup-plasty were acquired from patient's charts; 31 were interviewed with standardized questionnaires; 20 were examined physically; 19 received pedobarography, and 8 underwent dynamometric muscle function tests. Follow-up time averaged 6.5 years. RESULTS: The mean range of motion (ROM) in the ankle joint was 8° dorsiflexion and 15° plantar flexion. Most patients achieved plantigrade foot position and the majority developed gait without orthotic devices. As expected, maximum dorsiflexion torque averaged a third of the non-operated leg, according to reduced muscle diameter and strength of the transferred muscle. Pressure distribution of the sole during gait was not relevantly altered by the tendon transfer compared to the non-operated leg. Most patients were satisfied with the operative results and reported a significant increase in quality of life. CONCLUSIONS: Fusion of the transposed posterior tibial, anterior tibial and the peroneus longus tendon prevents drop foot deformity sufficiently. The stirrup mechanism, in combination with tenodesis of the toe extensors, provides a balanced foot and avoids equinovarus and cavus deformity without immobilizing the ankle joint. Improvements in quality of life parameters justify the risk of the operative procedure for the patient. SN - 1434-3916 UR - https://www.unboundmedicine.com/medline/citation/21246379/Tendon_transfers_for_drop_foot_correction:_long_term_results_including_quality_of_life_assessment_and_dynamometric_and_pedobarographic_measurements_ L2 - https://dx.doi.org/10.1007/s00402-010-1231-z DB - PRIME DP - Unbound Medicine ER -