Surgical Treatment of Complete Foot Drop: Partial Tibial Nerve Transfer to the Motor Branch of the Tibialis Anterior: 2-Dimensional Operative Video

Abstract

This video will be demonstrating the surgical treatment of complete foot drop with partial tibial nerve transfer to the motor branch of the tibialis anterior. Foot drop occurs when there is injury to the deep peroneal nerve that results in the paralysis of the tibialis anterior muscle and subsequent loss of ankle dorsiflexion.1-5 The patient who is the subject of this video is a 27-yr-old female with a 6-mo history of foot drop. She presented with complete loss of ankle dorsiflexion and great toe extension due to traumatic fall on her left knee while running. Upon physical examination, she had all the features of complete foot drop with loss of ankle dorsiflexion and ankle eversion. She also had decreased sensation to light touch over left dorsal foot, left great toe, and left lateral lower leg. The patient has consented to this procedure. The partial tibial nerve transfer to the motor branch of tibialis anterior muscle is the preferred treatment option for foot drop as it restores ankle dorsiflexion with minimal donor site complications. At 12 mo postsurgery, she has regained 4/5 for ankle dorsiflexion on motor testing compared to the 0/5 she had preoperatively.

Keywords: Foot drop; Partial tibial nerve transfer; Peroneal nerve injury; Tibialis anterior motor branch.