Surgical Management of Complete Footdrop via Partial Tibial Nerve Transfer to the Motor Branch of the Tibialis Anterior
This video demonstrates the surgical management of complete footdrop via partial tibial nerve transfer to the motor branch of the tibialis anterior. Footdrop results from injury to the deep peroneal nerve, causing paralysis of the tibialis anterior muscle and subsequent loss of ankle dorsiflexion. The patient shown in this video is a 27-year-old woman with a 6-month history of footdrop. She had complete loss of ankle dorsiflexion and great toe extension after a traumatic fall on her left knee while running. On physical examination, the patient had all the characteristic features of complete footdrop, with decreased sensation to light touch over the left dorsal foot, left great toe, and left lateral lower leg. The patient also had loss of ankle dorsiflexion and ankle eversion. Partial tibial nerve transfer to the motor branch of the tibialis anterior is the preferred treatment option for the management of footdrop because it restores ankle dorsiflexion with minimal donor site complications. The patient had 4/5 ankle dorsiflexion strength on motor testing at 12 months postoperatively compared with 0/5 ankle dorsiflexion strength preoperatively.