Botox as an adjuvant to tendon transfer for foot drop.
The authors' hypothesis was that weakening the gastrocnemius muscle at the time of tendon transfer will reduce the risk of rupture and facilitate faster rehabilitation with increased active dorsiflexion and improved overall outcome, because the transferred tendon is spared the antagonistic effect of the gastrocnemius during the early recovery period. A retrospective chart review identified 12 patients who underwent a tibialis posterior tendon (PTT) transfer with gastrocnemius Botox injection for foot drop. All statistical analyses were conducted using SAS version 9.2 (SAS Institute, Inc., Cary, North Carolina). There were no failures or tendon ruptures. All patients had zero dorsiflexion (DF) strength preoperatively, and those with DF strength documented postoperatively had a mean DF strength at final clinical evaluation of 3.9 (p < .001) with a mean active DF of 4°. It was concluded that gastrocnemius chemodenervation with Botox at the time of PTT transfer is a safe and effective means of restoring active dorsiflexion.
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Tobin T
TT
Eckel
James A
JA
Nunley
D000293:Adolescent; D000328:Adult; D019274:Botulinum Toxins, Type A / Q000008:administration & dosage*; D005260:Female; D005500:Follow-Up Studies; D005684:Gait / Q000502:physiology*; D020233:Gait Disorders, Neurologic / Q000503:physiopathology / Q000534:rehabilitation*; D006801:Humans; D007273:Injections, Intramuscular; D008297:Male; D008875:Middle Aged; D009465:Neuromuscular Agents / Q000008:administration & dosage; D012189:Retrospective Studies; D013709:Tendon Transfer / Q000379:methods*; D055815:Young Adult
D009465:Neuromuscular Agents; D019274:Botulinum Toxins, Type A