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Functional Outcomes Following Anterior Transfer of the Tibialis Posterior Tendon for Foot Drop Secondary to Peroneal Nerve Palsy.
Foot Ankle Int. 2017 Jun; 38(6):627-633.FA

Abstract

BACKGROUND

This retrospective comparative study reports the practical function in daily and sports activities after tibialis posterior tendon transfer for foot drop secondary to peroneal nerve palsy.

METHODS

Seventeen patients were followed for a minimum of 3 years after tibialis posterior tendon transfer for foot drop secondary to peroneal nerve palsy. Matched controls were used to evaluate the level of functional restoration. Functional evaluations included American Orthopaedic Foot & Ankle Society (AOFAS) scores, Foot and Ankle Outcome Score (FAOS), Foot and Ankle Ability Measure (FAAM) scores, and isokinetic muscle strength test. Radiographic evaluation for the changes of postoperative foot alignment included Meary angle, calcaneal pitch angle, hindfoot alignment angle, and navicular height.

RESULTS

Mean AOFAS, FAOS, and FAAM scores significantly improved from 65.1 to 86.2, 55.6 to 87.8, and 45.7 to 84.4 points at final follow-up, respectively. However, all functional evaluation scores were significantly lower as compared to the control group (P < .001). Mean peak torque (60 degrees/sec) of ankle dorsiflexors, plantarflexors, invertors, and evertors at final follow-up were 7.1 (deficit ratio of 65.4%), 39.2, 9.8, and 7.3 Nm, respectively. These muscle strengths were significantly lower compared to the control group (P < .001). No significant differences in radiographic measurements were found, and no patients presented with a postoperative flat foot deformity. One patient (5.9%) needed an ankle-foot orthosis for occupational activity.

CONCLUSIONS

Anterior transfer of the tibialis posterior tendon appears to be an effective surgical option for paralytic foot drop secondary to peroneal nerve palsy. Although restoration of dorsiflexion strength postoperatively was about 33% of the normal ankle, function in daily activities and gait ability were satisfactorily improved. In addition, tibialis posterior tendon transfer demonstrated no definitive radiographic or clinical progression to postoperative flat foot deformity at intermediate-term follow-up.

LEVEL OF EVIDENCE

Level IV, retrospective case series.

Authors+Show Affiliations

1 Department of Orthopaedic Surgery, College of Medicine, Chungbuk National University, Cheongju, Korea.1 Department of Orthopaedic Surgery, College of Medicine, Chungbuk National University, Cheongju, Korea.1 Department of Orthopaedic Surgery, College of Medicine, Chungbuk National University, Cheongju, Korea.2 Department of Orthopaedic Surgery, National Police Hospital, Seoul, Korea.3 Department of Orthopaedic Surgery, School of Medicine, University of California, Los Angeles, CA, USA.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

28552040

Citation

Cho, Byung-Ki, et al. "Functional Outcomes Following Anterior Transfer of the Tibialis Posterior Tendon for Foot Drop Secondary to Peroneal Nerve Palsy." Foot & Ankle International, vol. 38, no. 6, 2017, pp. 627-633.
Cho BK, Park KJ, Choi SM, et al. Functional Outcomes Following Anterior Transfer of the Tibialis Posterior Tendon for Foot Drop Secondary to Peroneal Nerve Palsy. Foot Ankle Int. 2017;38(6):627-633.
Cho, B. K., Park, K. J., Choi, S. M., Im, S. H., & SooHoo, N. F. (2017). Functional Outcomes Following Anterior Transfer of the Tibialis Posterior Tendon for Foot Drop Secondary to Peroneal Nerve Palsy. Foot & Ankle International, 38(6), 627-633. https://doi.org/10.1177/1071100717695508
Cho BK, et al. Functional Outcomes Following Anterior Transfer of the Tibialis Posterior Tendon for Foot Drop Secondary to Peroneal Nerve Palsy. Foot Ankle Int. 2017;38(6):627-633. PubMed PMID: 28552040.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Functional Outcomes Following Anterior Transfer of the Tibialis Posterior Tendon for Foot Drop Secondary to Peroneal Nerve Palsy. AU - Cho,Byung-Ki, AU - Park,Kyoung-Jin, AU - Choi,Seung-Myung, AU - Im,Se-Hyuk, AU - SooHoo,Nelson F, Y1 - 2017/02/01/ PY - 2017/5/30/entrez PY - 2017/5/30/pubmed PY - 2017/11/14/medline KW - foot drop KW - functional outcomes KW - peroneal nerve palsy KW - tibialis posterior tendon KW - transfer SP - 627 EP - 633 JF - Foot & ankle international JO - Foot Ankle Int VL - 38 IS - 6 N2 - BACKGROUND: This retrospective comparative study reports the practical function in daily and sports activities after tibialis posterior tendon transfer for foot drop secondary to peroneal nerve palsy. METHODS: Seventeen patients were followed for a minimum of 3 years after tibialis posterior tendon transfer for foot drop secondary to peroneal nerve palsy. Matched controls were used to evaluate the level of functional restoration. Functional evaluations included American Orthopaedic Foot & Ankle Society (AOFAS) scores, Foot and Ankle Outcome Score (FAOS), Foot and Ankle Ability Measure (FAAM) scores, and isokinetic muscle strength test. Radiographic evaluation for the changes of postoperative foot alignment included Meary angle, calcaneal pitch angle, hindfoot alignment angle, and navicular height. RESULTS: Mean AOFAS, FAOS, and FAAM scores significantly improved from 65.1 to 86.2, 55.6 to 87.8, and 45.7 to 84.4 points at final follow-up, respectively. However, all functional evaluation scores were significantly lower as compared to the control group (P < .001). Mean peak torque (60 degrees/sec) of ankle dorsiflexors, plantarflexors, invertors, and evertors at final follow-up were 7.1 (deficit ratio of 65.4%), 39.2, 9.8, and 7.3 Nm, respectively. These muscle strengths were significantly lower compared to the control group (P < .001). No significant differences in radiographic measurements were found, and no patients presented with a postoperative flat foot deformity. One patient (5.9%) needed an ankle-foot orthosis for occupational activity. CONCLUSIONS: Anterior transfer of the tibialis posterior tendon appears to be an effective surgical option for paralytic foot drop secondary to peroneal nerve palsy. Although restoration of dorsiflexion strength postoperatively was about 33% of the normal ankle, function in daily activities and gait ability were satisfactorily improved. In addition, tibialis posterior tendon transfer demonstrated no definitive radiographic or clinical progression to postoperative flat foot deformity at intermediate-term follow-up. LEVEL OF EVIDENCE: Level IV, retrospective case series. SN - 1944-7876 UR - https://www.unboundmedicine.com/medline/citation/28552040/Functional_Outcomes_Following_Anterior_Transfer_of_the_Tibialis_Posterior_Tendon_for_Foot_Drop_Secondary_to_Peroneal_Nerve_Palsy_ L2 - http://journals.sagepub.com/doi/full/10.1177/1071100717695508?url_ver=Z39.88-2003&amp;rfr_id=ori:rid:crossref.org&amp;rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -