Foot drop surgery should be the last resort for a person with a dropped foot condition since there are a lot of treatments available for treating this kind of condition. However, if the causes of foot drop are due to direct trauma to the dorsiflexors and nerve insults it may need a direct surgical repair.
A tendon transfer surgery is done if the cause of your foot condition is about the Achilles tendon, you may need this kind of surgery for a direct repair. This procedure is accomplished via an open Z-lengthening of tendon to allow for a minimum of 15 degrees of passive dorsiflexion. The route of transfer of the posterior tibial tendon may be through the circimtibial or intraosseous membrane. Once the transfer route is preferred, the point of fixation maybe a tendon-to-tendon or tendon-to-bone.
- Tendon-to-tendon fixation- The points of attachment are the peroneus brevis or tertius or extensor digitorium longus tendons for the lateral slip and the other one is the tibialis anterior or extensor hallucis longus for the medial slip.
- Tendon-to-bone fixation- its point of attachment is on the osseous tunnel in the metatarsal bones. Bridle procedure is the popular procedure foot drop surgery for tendon-to-bone attachment. This is by inserting the posterior tibial tendon into the second cuneiform bone. Combined with anastomosis of the posterior tibial tendon transfer to the anterior tibial tendon and the rerouted peroneus longus tendon in front of the lateral malleolus to balance the foot in dorsiflexion.
During neurotendinous transposition, the lateral head of the gastrocnemous is transposed to the tendons of the anterior muscle group with concurrent transposition of the proximal end of the deep peroneal nerve. The nerve is being sutured to the motor nerve of the lateral head of the gastrocnemius. This procedure restores active voluntary dorsiflexion of the foot and automatic walking. Furthermore, this transfer avoids use of an opponent muscle to the paralytic muscle groups and avoiding retraining to attain dorsiflexion.
As with many surgeries, complications may occur. So, before you undergo a surgery, check out first other alternative treatments that may help to with your present condition. Foot drop surgery is the ultimate solution when you cannot find any alternative remedy at all.