Effectiveness of tibialis posterior tendon transfer for foot drop secondary to peroneal nerve palsy

Objective: To investigate the effectiveness of tibialis posterior tendon transfer for foot drop secondary to peroneal nerve palsy. Methods: The clinical data of 21 patients with unilateral foot drop secondary to peroneal nerve palsy between October 2009 and September 2016 was retrospectively analyzed. There were 12 males and 9 females with an average age of 32.1 years (range, 23-47 years). The causes of peroneal nerve injury were iatrogenic injury in 7 cases, tibiofibular fractures combined with compartment syndrome in 5 cases, nerve exploration surgery after stab or cut injury in 3 cases, direct violence in 4 cases, and the fibular head fracture in 2 cases. The average time from injury to operation was 5.6 years (range, 2-8 years). There was 1 case of hallux valgus and 5 cases of toe flexion contracture. The American Orthopaedic Foot and Ankle Society (AOFAS) ankle and hindfoot scores, Foot and Ankle Ability Measure (FAAM) scores, range of motion (ROM), and dorsiflexion strength of ankle joint were used to evaluated the ankle function. Radiographic evaluation for the changes of postoperative foot alignment included Meary angle, calcaneal pitch angle, and hindfoot alignment angle. 结果: 术后切口均Ⅰ期愈合。患者均获随访，随访时间 18～42 个月，平均 30.2 个月。患者踝关节背伸肌力由术前 0 级恢复至 3～4 级。随访期间未出现平足畸形、爪形趾。末次随访时，Meary 角、跟骨倾斜角以及后足力线角与术前比较，差异均无统计学意义（ P>0.05）。末次随访时，患侧 AOFAS 评分、FAAM 评分、踝关节背伸活动度均较术前显著提高（ P<0.05），跖屈活动度与术前差异无统计学意义（ t=4.239， P=0.158）。健、患侧踝关节背伸活动度及 AOFAS 评分、FAAM 评分差异均有统计学意义（ P<0.05），跖屈活动度差异无统计学意义（ t=2.319， P=0.538）。. 结论: 胫后肌腱转位治疗腓总神经损伤源性足下垂畸形有效，患者踝关节功能改善明显，术后早期未出现继发性平足畸形。.