The results of anterior transfer of the posterior tibial tendon for peroneal palsy secondary to trauma in ten patients treated at the Mayo Clinic have been reviewed and analyzed. In all patients the tendon was transferred in a long spiral manner around the medial surface of the tibia to the dorsum of the foot and triple arthrodesis was performed.
The results of this study re-emphasize that transfer of the posterior tibial tendon to the dorsum of the foot satisfactorily restores the ability to dorsiflex the foot when persistent palsy of the common peroneal nerve is present. Transfer of the posterior tibial tendon around the medial side of the tibia, rather than through the interosseous membrane, gives satisfactory results if the original technique described by Ober is adhered to. Transfer of the posterior tibial tendon should be accompanied by stabilization of the foot, except, perhaps, in the young child. Persistent palsy of the common peroneal nerve is comparatively frequent. The annoying equinovarus gait or the use of a drop-foot brace can be eliminated in most instances by anterior transplantation of the posterior tibial tendon combined with triple arthrodesis.
Mayo Clinic and Mayo Foundation, Rochester