Restoration of active foot extension following peroneal nerve palsy
Spiroch, P.; Cizmár, I.; Freiwald, J.; Palcák, J.
Rozhledy V Chirurgii Mesicnik Ceskoslovenske Chirurgicke Spolecnosti 91(3): 151-157
2012
ISSN/ISBN: 0035-9351 PMID: 22881080 Document Number: 659564
Common peroneal nerve palsy is the commonest lower extremity peripheral paresis. The foot drop and inability or difficulty to move the ankle and toes dorsally and inability to perform foot pronation is a debilitating condition for the patient. Tendon transfer is a treatment option often used to restore the foot function after the peroneal palsy in cases when reinervation is not clinically satisfactory. The study group included 14 patients treated in the Trauma department of FNO either for common or deep peroneal nerve paresis, or for isolated lesion of the anterior tibial muscle. Active muscles, i.e.the posterior tibial muscle (13 patients) or long peroneal muscle (1 patient) were used for the movement restoration procedure. The tendons were anchored to the cuneiform bone. In all the patients, active foot extension was restored, with the average range of motion of 12.3 degrees (4-20) and with sufficient muscle strength. Based on the Stanmore score assessment, the subjects showed good results, reaching 87-100 points. The posterior tibial muscle tendon transfer, or peroneus longus muscle tendon transfer lead to restoration of active extension of the foot. The reconstruction procedure results in a minor restriction of the ankle range of motion. Considering the foot functionality, it is better to perform the transfer with a slight preload of the tendon, in order to achieve adequate postoperative ankle extension.