What Is Foot Drop

Foot drop is an inability to lift the front of the foot during walking due to weakness or paralysis of the muscles that dorsiflex the ankle It often results from injury to the common peroneal nerve around the knee sciatic nerve damage spinal root compression or certain neurological diseases People with foot drop lift their hip and knee higher to avoid tripping and may drag or slap the foot on the ground This gait pattern is tiring unsafe and socially distressing When nerve recovery fails to occur despite adequate time and earlier treatments tendon transfer surgery can re route functioning muscles to take over the lost action

Principle of Tendon Transfer

Tendon transfer uses a functioning muscle with a preserved nerve supply and strength to substitute for a paralysed one by changing the tendon attachment point The donor muscle should have similar line of pull and be expendable in its original role For foot drop the tibialis posterior muscle which normally inverts and plantarflexes the foot is commonly chosen as a donor Its tendon is detached from its insertion on the midfoot and rerouted to the front of the ankle or foot so that when it contracts it lifts the foot instead of turning it inward

Tibialis Posterior Tendon Transfer Procedure

Under anaesthesia the surgeon exposes and releases the tibialis posterior tendon behind the inner ankle and at its insertion then passes it through the interosseous membrane between the tibia and fibula or around the tibia to the front compartment The tendon is then attached to the tendons of dorsiflexor muscles such as tibialis anterior using weaving techniques like the Pulvertaft method or fixed to bone on the dorsal foot The foot is positioned in neutral or slight dorsiflexion during fixation to set the correct tension In combined nerve and tendon transfer strategies described in recent literature distal nerve transfers may be added in select cases to further enhance function

Postoperative Care and Rehabilitation

Immediately after surgery the limb is immobilised in a plaster or splint that holds the ankle in neutral to protect the repair while healing begins After a few weeks the cast may be changed and then later replaced with a brace as physiotherapy starts Rehabilitation focuses first on passive and then active motion followed by motor re education where the patient learns to use the transferred tibialis posterior muscle for dorsiflexion rather than inversion Over months strengthening and gait training allow most patients to walk with a heel to toe pattern without a brace Published series show high satisfaction rates with restored dorsiflexion and low complication rates when surgery and rehabilitation are performed in experienced centres

Other Tendon Transfers for Limb Palsy

Similar principles are applied in the upper limb for radial nerve palsy where wrist and finger extensors are paralysed Here flexor or pronator muscles can be rerouted to restore opening of the hand and wrist extension In brachial plexus injuries and cerebral palsy multiple tendon transfers may be combined to rebalance joints and improve functional grasp or release Each plan is tailored to the pattern of muscle strength and loss in that particular patient

Why Choose Livasa Hospitals for Tendon Transfer Surgery

Livasa Hospitals offer tendon transfer procedures as part of limb reconstruction and neuromuscular services with orthopaedic and plastic surgeons skilled in microsurgery nerve repair and complex soft tissue work Close collaboration with neurology physiotherapy and occupational therapy ensures that patients from across Punjab receive thorough preoperative counselling realistic goal setting and intensive postoperative rehabilitation to make the most of their new muscle tendon patterns and regain independent walking or hand function

Livasa Hospitals Punjab Network Contact

Livasa Healthcare Group Network of Multi speciality Hospitals in Punjab
Corporate Office Phase 8 Industrial Area Sector 73 Punjab 160071 India