Anterior Transfer of Tibialis Posterior through the Interosseous Membranes in Post Injection Drop Foot: The Expirence at CORU

Abstract

Post injection foot drop constitutes 7.6% of paediatric orthopaedic pathology seen in our unit. It commonly results from intragluteal injection with quinine in the treatment of malaria. The patients present with equinus or equinovarus foot deformity. Because of abnormal weight bearing, the deformity usually worsened with age. Anterior transfer of the tibialis posterior to the dorsum of the foot through the interosseous membrane has been described before and results reported. The tendon is either transfixed by tenodesis to the cuneiform or cuboids. In our series the latter method was used. This is a follow up of 30 patients who had surgeries at least 18 months after the injection and muscles power of the tendon transferred ranged from 3 to 5. We used three incisions of approximately 4cm each instead of four. Postoperative plaster of Paris cast for 6 weeks and ankle foot orthosis were used. We evaluated for correction and ability of the transferred tendon to actively dorsiflex at the ankle joint. Nineteen patients had good results 8 fair and 3 poor there was no neurovascular deficit. The purpose of this paper is to outline our outcome and technique of anterior transfer of the tibialis posterior through the interosseous membrane.