Abstract: Introduction: The transfer of the posterior tibial tendon is the most commonly used surgical procedure to address foot drop caused by paralysis of the foot dorsiflexor muscles. The aim of this study on posterior tibial tendon transfer in common fibular nerve paralysis is to evaluate the anatomical and functional outcomes of the foot and ankle following the transfer of the posterior tibial tendon.
Patients and Methods: This was a retrospective study covering a 72-month period (6 years). The study included 22 patients, comprising 15 men (68.2%) and 7 women (31.8%). The average age of the patients was 22.18 years, with a range of 6 to 58 years at the time of evaluation. Among the 22 patients, there were 11 cases of paralytic equinovarus foot and 11 cases of paralytic foot without deformity. Lower limb nerve conduction studies were performed in 13 patients (59.1%). The aetiologies found in our series included neurological, infectious, traumatic, and iatrogenic causes. All patients underwent tendon-to-bone transfer (Watkins technique).
Results: The average preoperative delay was 228.54 days (32 days to 683 days). The average postoperative follow-up was 37.95 months (3.16 years) with a range of 5 months to 73 months. Functional evaluation was performed using the Kitaoka AOFAS score. The average overall AOFAS score was significantly improved, ranging from 56.27/100 (min=33, max=74) preoperatively to 80.14/100 (min=48, max=97) postoperatively. Patients with traumatic etiology had a better AOFAS score after the transfer. Patient subjective satisfaction was also an evaluation criterion, with 81.8% (18/22) of patients being satisfied or very satisfied with the intervention.
