Abstract
Peroneal palsy with loss of active dorsal flexion in foot can be surgically treated by anterior transfer of tibialis posterior tendon. Two techniques are available, classic and modified Barr's technique of the anterior transfer of tibialis posterior tendon, with different place of tendon's reinsertion. The aim of the study is evaluation of the degree of active dorsal flexion in foot, and appearance of varus position and hipercorrection of the foot, by comparing the results of the two operative techniques. The study included 40 patients with peroneal irreparable palsies, divided into two equally sized groups. The first group was treated by classic Barr's technique. The other group of patients was treated by modified Barr's technique. The group treated by modified Barr's technique exhibited better functional results. Active dorsal flexion achieved between 950 (in 35% cases) and 900 (in 50% cases), while varus position and hipercorrection of the foot were absent. In the second group of 20 patients, treated by classic Barr's technique, 800 (40%) and 900 (25%) of active dorsal flexion, indicated worse functional postoperative results. Active dorsal flexion of 700 achieved by this method in two cases (10%), represents unsatisfactory functional result. Varus position of the foot was recorded in 5 cases (25%) and hipercorrection in 4 cases (20%). Modified Barr's technique is surgical method with better functional and postoperative results in treatment of irreparable peroneal palsy.
Highlights
Irreparable peroneal palsies, without possibility of functional recovery, can be treated by anterior transfer of tibialis posterior tendon
We have evaluated the results of operative treatment of patients with irreparable peroneal palsies, loss of active dorsal flexion in foot and functional range of motion in the ankle joint
The first group was treated by classic Barr’s technique and the second group was treated by modified Barrs technique
Summary
Irreparable peroneal palsies, without possibility of functional recovery, can be treated by anterior transfer of tibialis posterior tendon. Anterior transfer of tibialis posterior tendon, which primary function is plantar flexion of the foot, with reinsertion on cuboid, or one of the cuneiform or metatarsal bones, is convenient type of tendon transfer in irreparable peroneal palsy ( ). HATT’S MODIFICATION OF OBERS TECHNIQUE – reinsertion of tibialis posterior tendon on the medial cuneiform bone Anterior transfer of tibialis posterior tendon removes dynamic deformity of the foot, while establishing active dorsal flexion ( ). The aim of the study is to compare success of classic and modified Barr's techniques by evaluating the degree of active dorsal flexion after anterior transfer of tibialis posterior tendon and by observing unfavorable postoperative results in the form of varus position and hipercorrection of the foot
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