Tibialis Posterior Transfer for Foot Drop: Difference in Outcome for Two    Different Attachment Sites

Abstract

Objective: To compare the outcome of Posterior Tibialis tendon transfer to two different attachment sites in terms of post-surgery dorsiflexion strength. Study Design: Quasi-experimental study. Place and Duration of Study: Department of Plastic Surgery, Combined Military Hospital, Rawalpindi Pakistan, Jul 2020 to Jul 2021. Methodology: We studied a total of 30 patients who developed Common Peroneal Nerve palsy. Patients with previous surgery, especially those with posterior tibiali tendon transfer were excluded. Patients were divided into two equal groups of 15 patients each, with Group-A receiving surgery with the modified Barr’s technique while Group-B received classic Barr’s technique. All participants were followed up at six months for degree of ankle dorsiflexion, varus deformity and hypercorrection. Results: None of the cases which underwent modified Barr’s technique developed varus deformity, as opposed to 4(26.7%) cases with the classic technique (p=0.032). For hypercorrection, no cases were seen with the modified technique versus 5(33.3%) cases with the classic technique (p=0.014). All cases with the modified technique developed some improvement in active dorsiflexion with 14(93.3%) achieving normal range, while 12(80%) showed some improvement with the classic technique and only 7(46.7%) acquired normal range (p=0.018). Conclusion: The modified Barr’s technique was superior to the classic Barr’s technique for posterior tibialis transfer in cases of foot drop in terms of functional outcomes.

Keywords

• Attachment site, foot drop, tibialis posterior transfer.