Foot drop is caused by damage to the nerves to the leg that control the movement of lifting the foot up at the ankle joint. This damage can occur through a direct injury to the nerve or higher up in the leg or the low spine. If appropriate, foot drop can be treated with tendon transfer surgery; using a healthy tendon to replace and restore the movement of the inactive one.
What does the operation involve?
A tendon transfer operation is performed under general or spinal anaesthetic and takes about 1.5 hours. Three small incisions are made around the ankle and lower calf to allow a healthy tendon (the tibialis posterior) to be moved into the foot to now do the work of the paralysed tendons.
The foot is placed in the correct position so that the tension of the new tendon can be adjusted to the right length. Once this is completed the incision is closed up with stitches and the tendon transfer protected with a splint to hold the foot in the right position during the healing phase.
What to expect post surgery?
Specialist post-op care:
> Patient will need to stay in hospital for 1 to 2 nights after surgery.
> Foot to be kept rested and elevated for the first 8 to 10 days.
> Fibreglass cast will be fitted below the knee and is to be worn for 6 weeks following surgery.
> Physiotherapy will be required to improve strength and mobility and will advise when you are ready to start weight bearing.
> Patients with office based jobs can return to work after 2 to 4 weeks still wearing cast or a protective boot.
> Patients whose jobs involve physical activity may not return to work for up to 12 weeks.
> Recovery can be expected in 3 months and a full return to a complete range of activities can take up to 12 months.
What are the risks?
Common side effects:
> Stiffness in the ankle that can be improved with physiotherapy.
Uncommon but potential complications:
As with any operation problems may arise with an unexpected reaction to the anesthetic, excessive bleeding, blood clots or infection. Complications can occur during or after the procedure.