Combined distal tibial nerve transfer and tibialis posterior tendon transfer for foot drop correction: A surgical technique and case illustration

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Tendon transfers have traditionally been the mainstay for treating foot drop and improving gait and mobility. Recently, distal nerve transfers from the tibial to the deep peroneal nerve have been explored, but with limited success in achieving ankle dorsiflexion. We present a novel surgical technique combining both distal tibial nerve transfers (to both deep and superficial peroneal nerves) and tibialis posterior tendon transfer to the tibialis anterior (internal splint). This dual approach aims to achieve comprehensive foot drop correction through the reinnervation of foot dorsiflexors and improved ankle function. A case illustration highlights this combined technique’s surgical steps and potential benefits.