Technique Tip: Combined Suspensory and Aperture Fixation of Posterior Tibialis Tendon Anterior Transfer for Dropfoot

Abstract

Anterior transfer of the tibialis posterior tendon is a widely used technique to restore ankle dorsiflexion in patients suffering from a foot drop. One of the limitations of this procedure is the need for postoperative ankle immobilization, which can lead to a number of complications—muscle atrophy, joint stiffness, adhesions, and venous thromboembolism, to name a few. We present a new way of tendon docking which enables patients to weight-bear immediately after surgery, thus significantly reducing the above mentioned risks. This modification addresses the weakest point of the fixation—the tendon/screw interface, by utilizing a tension slide bicortical biceps button. Our initial case series of 8 patients (9 feet) has shown good results with no patients showing late radiologic or clinical loss of fixation of the construct at 6 months follow-up. Level of Evidence: Diagnostic Level IV–case series. See Instructions for Authors for a complete description of levels of evidence.