Fracture of calcaneum following drop foot surgery--a case report

The usual protocol for correction of drop foot in leprosy, a consequence of damage to the common peroneal nerve, is a tendon transfer, immobilisation to heal the tendon juncture and post-operative exercises to put the transfer into use. Tarsal disintegrations have been reported in literature in drop foot patients when the transferred tendons were inserted into the bone making a drill hole to ensure firm anchorage. Such disintegrations are rarely seen these days because bony insertion of the tendon transfers is not performed in the leprosy-affected foot. We report here a case of drop foot that developed a fracture of the calcaneum during the post-operative period after tibialis posterior two tail transfer (to tibialis anterior and extensor digitorum longus) along with lengthening of the tendoachillis. The case is interesting in the sense that osteoporosis and walking strains resulted in a fracture of the body of the calcaneum which healed with conservative treatment and controlled mobilisation of the patient.