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. 2009 Dec;33(6):1637-40.
doi: 10.1007/s00264-008-0704-y. Epub 2009 Jan 10.

Tibialis posterior transfer by interosseous route for the correction of foot drop in leprosy

R K Shah  1
Affiliations

Tibialis posterior transfer by interosseous route for the correction of foot drop in leprosy

R K Shah. Int Orthop. 2009 Dec.

Abstract
in English, French

This article summarises a prospective study to evaluate the long-term results produced by interosseous transfer of the tibialis posterior tendon for the correction of foot drop due to leprosy neuritis. The study was carried out in 120 feet in 69 patients. All patients had closed elongation of the tendo Achillis (ETA) before transfer of the bifurcated tibialis posterior tendon through the interosseous route to the tendons of tibialis anterior and peroneous tertius or brevis over the dorsum of feet. At final follow-up of average 24 months, all the patients with ETA had a significantly greater range of active dorsiflexion of more than 10 degrees above 90 degrees, which was not merely from the tenodesing effect. The results, in terms of improvement in gait and prevention of trophic changes, remained satisfactory. An interosseous route is preferred with split attachment to the tibialis anterior and to the peroneus brevis or tertius tendons.

Une étude prospective de façon à évaluer les résultats à longs termes du tranfert du tendon du jambier postérieur dans la correction des lésions du tendon d’achille secondaires à la lèpre. cette étude a permis d’évaluer 120 pieds chez patients. Tous les patients présentaient une élongation du tendon d’Achille avant transfert avec le jambier postérieur à travers la membrane inter-osseuse. au suivi final à 24 mois pour les patients ont été améliorés avec une flexion dorsale active de 100 à 90° sous effets de ténodèse. cette intervention améliore la marche et prévient des troubles trophiques. Il s’agit d’une intervention satisfaisante. Le transfert inter-osseux est préférable au simple agrafage du tendon tibial antérieur à l’utilisation du court peronier latéral ou du troisième fibulaire.

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