Lambrinudi Arthrodesis with Posterior Tibialis Transfer in Adult Drop-Foot

Abstract

The adult drop-foot is one of the most disabling disorders that affects gait and quality of life. Despite orthoses and orthopaedic shoes, the disability often progresses. We have used the Lambrinudi arthrodesis to correct the bony component of drop-foot in association with a posterior tibial tendon transfer to provide lateral ankle stability and active dorsiflexion. This study presents results obtained in a consecutive series of 19 patients. Nineteen patients (mean age, 54.7 years) were treated for drop-foot with an osseous dorsiflexing procedure according to Lambrinudi's original technique and a posterior tibial tendon transfer to the lateral cuneiforme bone. Outcome measurements included extended radiographic and clinical investigations, including the AOFAS Hindfoot Score, SF-36, ROM and VAS. The mean followup time was 39 (range, 24 to 62) months. The AOFAS Hindfoot Score improved from 38.9 preoperatively to 73.2 (p < 0.001) at last followup, and the SF-36 scores improved from 38.3 to 70.5 (p < 0.001). All patients were able to wear normal shoes at final followup. In this study of 19 patients, Lambrinudi arthrodesis combined with posterior tibial transfer proved to be a reliable and reproducible treatment for semi-rigid and rigid adult drop-foot caused by several aetiologies. It provided a stable correction of the adult drop-foot and high patient satisfaction in the mid- to long-term. In particular, it enabled the patient to wear normal shoes.