scholarly journals Case Series: Management of Foot Drop

2019 ◽  
pp. 1-6
Author(s):  
Isaac Olusayo Amole ◽  
Stephen Adesope Adesina ◽  
Adewumi Ojeniyi Durodola ◽  
Samuel Uwale Eyesan
Keyword(s):  
Case Series ◽  
Common Peroneal Nerve ◽  
Surgical Correction ◽  
Foot Drop ◽  
Tibialis Posterior ◽  
Corrective Surgery ◽  
Hansen's Disease ◽  
Hansen’S Disease ◽  
Tendo Achillis ◽  
Tibialis Posterior Transfer

Aim: To highlight the functional outcome of surgical management of foot drop in patients with Hansen disease. Case Presentation:  We present three cases of foot drop following Hansen’s disease that were managed surgically by Tibialis posterior transfer. The patients had preoperative physiotherapy for ten days and postoperative physiotherapy for four weeks. Their post-operative periods were uneventful and the corrections were satisfactory. Discussion: Involvement of common peroneal nerve in Hansen’s disease usually results in paralysis of the anterior tibial and/or peroneal muscles. Hansen’s disease patients with foot-drop walk with a ‘high-stepping gait’, lifting the leg high as if climbing steps even while walking on level ground. When the paralysis has been present for more than six months to one year without recovery, the best option of treatment at this stage is corrective surgery and the main aim of the corrective surgery is to restore active dorsiflexion of the foot so that the gait becomes normal. This is achieved by re-routing the tendon of Tibialis posterior muscle, brings that tendon to lie in front of the ankle and is anchored distally. If the tendo-achillis tendon is found to be tight, it should be lengthened as the first step of the Tibialis posterior transfer operation. Conclusion: Surgical correction of foot drop usually leads to restoration of active dorsiflexion of the foot thereby preventing development of secondary deformities and ulceration. Our patients were able to dorsiflex their feet after the surgical correction.

scholarly journals Case Series: Correcting Deformities: Eliminating the Fear of Stigma

2019 ◽  
pp. 1-5
Author(s):  
Isaac Olusayo Amole ◽  
Stephen Adesope Adesina ◽  
Adewumi Ojeniyi Durodola ◽  
Samuel Uwale Eyesan
Keyword(s):  
Case Series ◽  
Foot Drop ◽  
Nerve Paralysis ◽  
Hansen's Disease ◽  
Excellent Outcome ◽  
Governmental Agencies ◽  
Hansen’S Disease ◽  
Great Transformation ◽  
The Government ◽  
One Year

Aim: To show how the surgery helped to eliminate the fear of the stigma associated with Hansen’s disease. Presentation of Cases: We present a case series of two patients with right ulnar nerve paralysis and one patient with left foot drop. They all underwent surgery for correction of their deformities with excellent outcome. Discussion: From the cases presented it was clear that though all of them were treated with multi-drug therapy for one year but they were still living under the fear of stigmatization until they had their deformities corrected through surgery. There was a great transformation in the lives of these affected individuals when they had their deformities corrected through surgery. They all overcame their fear of stigmatization after the successful surgery. Conclusion: Correction of deformities is one of the ways of eliminating fear of stigmatization among the patients who have residual deformities after completing their treatment for Hansen’s disease. The government and non-governmental agencies could do more to make the service readily available and accessible to these individuals. This will help in reintegrating the treated individual back into the community and it will eventually lead to the closure of Leprosy camps.

scholarly journals Combined Suspensory and Aperture Fixation of Posterior Tibialis Tendon Anterior Transfer for Dropfoot

2020 ◽  
Vol 5 (4) ◽  
pp. 2473011420S0039
Author(s):  
Robbie Ray ◽  
Richard Navratil ◽  
Andrew Ogilvie ◽  
Thomas L. Lewis
Keyword(s):  
Common Peroneal Nerve ◽  
Interference Screw ◽  
Foot Drop ◽  
Tibialis Posterior ◽  
Pilot Hole ◽  
Suspensory Fixation ◽  
Peroneal Nerve Injury ◽  
Technical Modifications ◽  
Additional Stability ◽  
Aperture Fixation

Category: Other; Trauma Introduction/Purpose: Anterior transfer of the tibialis posterior tendon (TPT) can restore ankle dorsiflexion in patients with foot drop. A limitation of this procedure is the need for postoperative ankle immobilisation. We present the results of a novel dual method of TPT docking which infers immediate stability, allowing early weightbearing. Methods: 8 patients underwent 9 tendon transfers,age range of 28-52 years. 3 patients had dropfoot from common peroneal nerve injury, 6 cases were part of a complex cavovarus or spastic equinovarus correction. The TPT is passed to the dorsum of the foot through the interosseous membrane. The docking site is prepared with a bicortical pilot hole followed by unicortical overreaming. The TPT is whipstitched and an Arthrex biceps button is threaded to the sutures. The button is passed bicortical and flipped using a tension slide technique give stable suspensory fixation. Additional stability is conferred by overpassing an Arthrex biotenodesis screw giving aperture fixation. Patients are immobilised in a boot and allowed to weightbear immediately. Results: Follow up was 6 months. There was difficulty in docking of suspensory fixation in two of the early cases. These patients had aperture fixation and were immobilised non weightbearing in a cast for 6 weeks. With technical modifications, all subsequent patients had dual fixation. At 6 months there were no radiological or clinical failures of fixation. Patients without other underlying issues were able to mobilise splint free at 6 months. All patients were satisfied with their procedure. Conclusion: Aperture fixation with an interference screw has become the gold standard for TPT transfer, however, patients still need a prolonged period of immobilisation. Combined suspensory and aperture fixation is technically straightforward and seems to give more initial stability allowing early weightbearing. Further prospective studies and biomechanical studies are needed to validate this technique.

scholarly journals The anatomic location and importance of the tibialis posterior fascicular bundle at the sciatic nerve bifurcation: report of 3 cases

2019 ◽  
Vol 131 (6) ◽  
pp. 1869-1875 ◽  
Author(s):  
Thomas J. Wilson ◽  
Andres A. Maldonado ◽  
Kimberly K. Amrami ◽  
Katrina N. Glazebrook ◽  
Michael R. Moynagh ◽  
...  
Keyword(s):  
Sciatic Nerve ◽  
Peroneal Nerve ◽  
Tibial Nerve ◽  
Common Peroneal Nerve ◽  
Foot Drop ◽  
Preoperative Imaging ◽  
Tibialis Posterior ◽  
Severe Injuries ◽  
Nerve Action ◽  
Internal Neurolysis

The authors present the cases of 3 patients with severe injuries affecting the peroneal nerve combined with loss of tibialis posterior function (inversion) despite preservation of other tibial nerve function. Loss of tibialis posterior function is problematic, since transfer of the tibialis posterior tendon is arguably the best reconstructive option for foot drop, when available. Analysis of preoperative imaging studies correlated with operative findings and showed that the injuries, while predominantly to the common peroneal nerve, also affected the lateral portion of the tibial nerve/division near the sciatic nerve bifurcation. Sunderland’s fascicular topographic maps demonstrate the localization of the fascicular bundle subserving the tibialis posterior to the area that corresponds to the injury. This has clinical significance in predicting injury patterns and potentially for treatment of these injuries. The lateral fibers of the tibial division/nerve may be vulnerable with long stretch injuries. Due to the importance of tibialis posterior function, it may be important to perform internal neurolysis of the tibial division/nerve in order to facilitate nerve action potential testing of these fascicles, ultimately performing split nerve graft repair when nerve action potentials are absent in this important portion of the tibial nerve.

scholarly journals A case series of pure neural leprosy in patients diagnosed in a specialized center for the control of Hansen’s disease in Colombia

Biomédica ◽  
2018 ◽  
Vol 38 (2) ◽  
pp. 153-161
Author(s):  
Héctor Serrano-Coll ◽  
Olinto Mieles ◽  
Calixto Escorcia ◽  
Amparo Díaz ◽  
Camilo Beltrán ◽  
...  
Keyword(s):  
Case Series ◽  
Hansen's Disease ◽  
Hansen’S Disease ◽  
Specialized Center

La lepra neural pura se presenta como una neuropatía periférica sin presencia de lesiones cutáneas.La verificación del diagnóstico mediante el índice bacilar y la histopatología, no es posible en la mayoría de los pacientes.Se describen cuatro casos de lepra neural pura diagnosticados por clínica; la evolución de tres de los pacientes que recibieron tratamiento específico fue satisfactoria, en tanto que la otra paciente presentó deterioro progresivo a pesar de las medidas terapéuticas. Todos los pacientes fueron atendidos en un centro especializado en el manejo y control de la enfermedad de Hansen, ubicado en el municipio de Contratación, Santander, Colombia.

Sign in / Sign up

Export Citation Format

Share Document