Soft Tissue Management and Tibialis Posterior Tendon Transfer in Acute Correction for Neglected Drop Foot Deformity

Area of Science:

• Orthopedic Surgery
• Reconstructive Surgery

Background:

• Acute correction of rigid drop foot deformity is challenging due to potential medial ankle skin defects.
• Existing methods may not adequately address soft tissue complications.

Purpose of the Study:

• To present an innovative surgical technique for acute functional correction of rigid drop foot deformities.
• To evaluate the efficacy of a flap and partial-thickness skin graft for medial defect closure in this context.

Main Methods:

• Retrospective evaluation of 18 patients treated between 2010 and 2016.
• Surgical technique involved flap and partial-thickness skin graft for medial defect closure.
• Patients had firearm-related nerve injury causing foot drop, with corrections performed after an average of 14.6 months post-injury.

Main Results:

• 78% of patients (14/18) recovered without complications.
• Ankle flexion contracture improved from an average of 34° to 2.2° dorsiflexion.
• Minor complications included partial skin graft loss (3 patients) and superficial infection (1 patient).

Conclusions:

• Acute correction of rigid drop foot deformity is feasible with effective medial skin closure using a flap and skin graft.
• This technique offers a solution to prevent skin defects and achieve functional recovery.
• Low rates of soft tissue complications were observed, with no instances of pes planus.