Surgery of foot drop in leprosy by tibialis posterior transfer

In the surgery of foot drop the common method of correction is by transfer of tibialis posterior muscle, either to the joint capsule in the middle of the foot (Selvapandian's method) or a double transfer to the toe extensor tendons (Srinivason's method). A retrospective study was done to compare the results of surgery done by those two methods at the Sacred Heart Leprosy Centre, Kumbakonam with a follow-up ranging from one to nine years where 78 feet had tibialis posterior transfer by Srinivasan's method and 20 by Selvapandian-Brand method. Restoration of the normal heel-toe gait was the criteria taken to evaluate the results. Good results were obtained by either method in nearly 70% of cases. The post operative findings and the causes of failure are analysed in detail. The pre and post-operative physiotherapy methods which mainly contribute a successful result are described and stressed.