[A long-term follow-up result of posterior tibialis muscle transfer for foot-drop in leprosy patients].
OBJECTIVE
To determine the long-term results and possible complications of the posterior tibialis transfer in correction of the foot-drop in leprosy patients, and to compare the results by the circum-tibial and interosseous routes.


METHODS
From January to October 2001, 37 cases (treated from October 1989 to October 1999) were followed up. Walking gait, active dorsiflexion and plantar flexion of the ankle joint, deformities of the feet, and patients' satisfaction were recorded.


RESULTS
Of 37 patients, 22 were treated by circum-tibial transfer, 15 by interosseous transfer. All patients' Achilles tendons were lengthened. Excellent and good results were obtained in 30 cases (86%). The active dorsiflexion was better by interosseous route than by circum-tibial route. Out of 35 patients followed up for 2-11 years (4 years on average), 14 had talipes varus in 22 by circum-tibial transfer, 2 had talipes varus in 13 by interosseous transfer; there was significant difference between two routes (P < 0.05). The complications included drop-toe(5 cases), muscle atrophy (4 cases), tendon rupture (1 case) and tendon adhesion (1 case).


CONCLUSIONS
Tibialis posterior transfer with elongation of tendo Achilles can obtain excellent results in treating foot-drop due to leprosy. Interosseous route is preferred and physiotherapy is emphasized pre- and postoperatively.
Qian
Jian-ge
JG
Zhejiang Provincial Institute of Dermatology, Deqing Zhejiang, P.R. China 313202.
Yao
Wei-hua
WH
Qian
Chong-zu
CZ
D000125:Achilles Tendon / Q000601:surgery; D000328:Adult; D005260:Female; D005500:Follow-Up Studies; D005531:Foot Deformities, Acquired / Q000209:etiology / Q000601:surgery*; D006801:Humans; D007918:Leprosy / Q000150:complications*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000517:prevention & control; D013709:Tendon Transfer / Q000379:methods*; D016896:Treatment Outcome