Tibialis Posterior Transfer for Foot Drop: Difference in Outcome for Two Different Attachment Sites

Article Information

Title: Tibialis Posterior Transfer for Foot Drop: Difference in Outcome for Two Different Attachment Sites

Authors: Shah Faisal, Shahid Hameed Choudhary, Abdul Majid, Farman Mahmood, Tabish Samuel, Afia Ayub

Journal: Pakistan Armed Forces Medical Journal (PAFMJ)

HEC Recognition History

Category	From	To
Y	2024-10-01	2025-12-31
Y	2023-07-01	2024-09-30
Y	2021-07-01	2022-06-30
Y	2020-07-01	2021-06-30
Y	1900-01-01	2005-06-30

Publisher: Army Medical College, Rawalpindi.

Country: Pakistan

Year: 2024

Volume: 74

Issue: 4

Language: English

Keywords: Attachment sitefoot droptibialis posterior transfer.

Abstract

Objective: To compare the outcome of Posterior Tibialis tendon transfer to two different attachment sites in terms of post-surgery dorsiflexion strength.
Study Design: Quasi-experimental study.
Place and Duration of Study: Department of Plastic Surgery, Combined Military Hospital, Rawalpindi Pakistan, Jul 2020 to Jul 2021.
Methodology: We studied a total of 30 patients who developed Common Peroneal Nerve palsy. Patients with previous surgery, especially those with posterior tibiali tendon transfer were excluded. Patients were divided into two equal groups of 15 patients each, with Group-A receiving surgery with the modified Barr’s technique while Group-B received classic Barr’s technique. All participants were followed up at six months for degree of ankle dorsiflexion, varus deformity and hypercorrection.
Results: None of the cases which underwent modified Barr’s technique developed varus deformity, as opposed to 4(26.7%) cases with the classic technique (p=0.032). For hypercorrection, no cases were seen with the modified technique versus 5(33.3%) cases with the classic technique (p=0.014). All cases with the modified technique developed some improvement in active dorsiflexion with 14(93.3%) achieving normal range, while 12(80%) showed some improvement with the classic technique and only 7(46.7%) acquired normal range (p=0.018).
Conclusion: The modified Barr’s technique was superior to the classic Barr’s technique for posterior tibialis transfer in cases of foot drop in terms of functional outcomes.

Disclaimer: The following sections are produced through an intensive multi-stage analytical pipeline developed by DefinePK, utilizing advanced natural-language processing, domain-specific knowledge models, and automated cross-referencing systems. Despite the rigor and computational effort involved, the generated summary may still contain inaccuracies or incomplete interpretations. Users are strongly advised to verify all critical information against the original paper and its authoritative sources.

Research Objective

To compare the outcome of Posterior Tibialis tendon transfer to two different attachment sites in terms of post-surgery dorsiflexion strength.

Methodology

A quasi-experimental study involving 30 patients with Common Peroneal Nerve palsy was conducted. Patients were divided into two groups: Group-A (15 patients) received the modified Barr's technique, and Group-B (15 patients) received the classic Barr's technique. Outcomes were assessed at six months post-surgery for ankle dorsiflexion, varus deformity, and hypercorrection. Data was analyzed using SPSS, with chi-square tests for qualitative variables and independent samples t-tests for quantitative variables.

Methodology Flowchart

                        graph TD
    A["Patient Recruitment n=30 with Common Peroneal Nerve Palsy"] --> B["Divide into two groups"];
    B --> C["Group-A: Modified Barr's Technique n=15"];
    B --> D["Group-B: Classic Barr's Technique n=15"];
    C --> E["Surgical Procedure"];
    D --> E["Surgical Procedure"];
    E --> F["6-Month Follow-up"];
    F --> G["Assess Dorsiflexion, Varus Deformity, Hypercorrection"];
    G --> H["Data Analysis SPSS"];
    H --> I["Compare Outcomes Between Groups"];
    I --> J["Conclusion: Modified Technique Superior"];

Discussion

The modified Barr's technique demonstrated superior functional outcomes for tibialis posterior transfer in foot drop cases compared to the classic technique, with a lower incidence of post-operative deformities and improved dorsiflexion. Trauma was the most common cause of Common Peroneal Nerve palsy in the study.

Key Findings

The modified Barr's technique resulted in no cases of varus deformity (vs. 26.7% with classic technique, p=0.032) and no cases of hypercorrection (vs. 33.3% with classic technique, p=0.014). All patients (93.3%) with the modified technique achieved normal dorsiflexion, compared to 46.7% with the classic technique (p=0.018).

Conclusion

The modified Barr's technique is superior to the classic Barr's technique for posterior tibialis transfer in cases of foot drop, leading to better functional outcomes, specifically improved dorsiflexion and reduced incidence of varus deformity and hypercorrection.

Fact Check

1. Varus Deformity Incidence: The classic technique resulted in varus deformity in 4 (26.7%) cases, while the modified technique had 0 cases (p=0.032).
2. Hypercorrection Incidence: The classic technique resulted in hypercorrection in 5 (33.3%) cases, while the modified technique had 0 cases (p=0.014).
3. Normal Dorsiflexion Achievement: 14 (93.3%) patients in the modified technique group achieved normal dorsiflexion, compared to 7 (46.7%) in the classic technique group (p=0.018).

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