Anterior transfer of tibialis posterior tendon for treating drop foot: Technique of enforcing tendon implantation to improve success rate

Purpose: An absolutely convincing technique of anterior transfer of the tibialis posterior (TP) tendon for treating drop foot has not been developed.Methods: Thirty-seven consecutive adult patients with drop foot owing to deep peroneal nerve injury were treated with bone-to-bone TP tendon transfer. The TP tendon with a small bony attachment was procured from the undersurface of the navicular. Cancellous bone graft procured from the distal tibial metaphysis was packed into the tunnel inlet. Side-to-side tendon suturing was performed between the TP tendon and tibialis anterior tendon.Results: Thirty-one patients were followed for a mean of 2.8 years (range, 1.2-4.8 years), and all achieved satisfactory outcome for the ankle. All patients achieved a normal gait after one year and at the latest follow-up.Conclusions: The described technique may provide a high success rate. This surgical technique is not complex, and complications are few.