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Updated: Feb 15, 2026

Author Spotlight: Integrating Mechanical and Biological Analysis in Tendinopathy Research
Published on: March 1, 2024
Tendon Transfers to Restore Ankle Dorsiflexion After Anterior Compartment Myonecrosis: A Case Report
Wesley Zhang Yang1, Joseph S Park, Seth Robert Yarboro
1Department of Orthopaedic Surgery (J.S.P. and S.R.Y.), School of Medicine (W.Z.Y.), University of Virginia School of Medicine, Charlottesville, Virginia.
Case:
A 47-year-old Caucasian woman spontaneously developed an isolated anterior compartment pressure of >100 mm Hg in the left leg. Despite fasciotomies, the musculature was nonviable and required debridement. Following Achilles tendon lengthening, a posterior tibial tendon (PTT) to anterior tibial tendon (ATT) transfer was supplemented with a flexor digitorum longus tendon transfer to the remaining PTT in order to prevent a flatfoot deformity while restoring active dorsiflexion.
Conclusion:
Preservation of the tendinous portion of the ATT during debridement allowed for transfer of the PTT to the ATT using a modified Pulvertaft transfer. This technique allowed early ambulation and restoration of active dorsiflexion, obviating the ongoing use of an ankle-foot orthosis.
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