Common peroneal nerve palsy has been reported to be the most frequent lower extremity palsy characterized by a supinated equinovarus
foot deformity and foot drop. Dynamic tendon transposition represents the gold standard for surgical restoration of dorsiflexion
of a permanently paralyzed foot. Between 1998 and 2005, we operated on a selected series of 16 patients with traumatic complete
common peroneal nerve palsy. In all cases, we performed a double tendon transfer through the interosseous membrane. The posterior
tibialis tendon was transferred to the tibialis anterior rerouted through a new insertion on the third cuneiform and the flexor
digitorum longus was transferred to the extensor digitorum longus and extensor hallucis longus tendons. All 16 patients were
reviewed at a minimum followup of 24 months (mean, 65 months; range, 24–114 months). The results were assessed using the Stanmore
system questionnaire and were classified as excellent in eight, good in five, fair in two, and poor in one. Postoperative
static and dynamic baropodometric evaluations also were performed. The proposed procedure, which provides an appropriate direction
of pull with adequate length and fixation, is a reliable new method to restore balanced foot dorsiflexion correcting the foot
and digit drop and producing a normal gait without the use of orthoses.
Level of Evidence: Level IV, therapeutic study. See the Guidelines for Authors for a complete description of levels of evidence.
Each author certifies that he or she has no commercial associations (eg, consultancies, stock ownership, equity interest,
patent/licensing arrangements, etc) that might pose a conflict of interest in connection with the submitted article.
Each author certifies that his or her institution has approved or waived approval for the human protocol for this investigation
and that all investigations were conducted in conformity with ethical principles of research.