Extramembranous transfer of the tibialis posterior tendon for the treatment of drop foot deformity in children.

Abstract

To study the efficacy of extramembranous transfer of the tibialis posterior (posterior tibial) tendon for the treatment of drop foot deformity in children. 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 to18 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. 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). 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.