Extramembranous Transfer of the Tibialis Posterior Tendon for the Treatment of Drop Foot Deformity in Children

Abstract

Background: To study the efficacy of extramembranous transfer of the tibialis posterior (posterior tibial) tendon for the treatment of drop foot deformity in children. Materials and Methods: This study included 24 patients (11 girls and 13 boys) with drop foot deformity, who underwent tibialis posterior tendon transfer. The mean age was 12.33 years (range: seven to 18 years), and the mean follow-up period was 32.54 months (range: 24 55 months). Drop foot developed due to different levels of nerve injury associated with trauma or surgical operation in 18 (75 %) patients, and due to meningomyelocele in six (25 %) patients. Tibialis posterior tendon was flipped from the anteromedial aspect of the tibia and transferred to the lateral cuneiform bone. The patients were evaluated via the Stanmore system questionnaire. Results: Evaluating the outcomes by the Stanmore system, poor results in two feet (8.3 %), fair in two feet (8.3 %), good in eight feet (33.3 %), and excellent in 12 (50 %) feet were obtained. All patients were satisfied with the postoperative outcomes. The mean active ankle dorsiflexion was 8.96 degrees (range: zero to 20 degrees). Conclusions: Extramembranous transfer of the tibialis posterior tendon is a quite successful method in retrieving active dorsiflexion of the foot in patients with drop foot deformity. It is a method which eliminates the need for orthosis and enhances the quality of life of patients.