New method for fixation point of tibialis posterior tendon transfer

 Background: The transfer of the tibialis posterior tendon to the dorsum of foot can restore the function of the paralyzed dorsiflexor muscles of the foot and ankle. In order to reduce the wound complication in the insertion site of tendon to bone by a plantar knop we used a new method of fixation by an absorbable screw inserted dorsally. Methods: we performed this operation on 15 patients in a 3 years period. All patients had drop foot deformity due to irreversible lesions of the peroneal nerve. The inclusion criteria was the peroneal nerve palsy that was not improved after 18 months even by using nerve releasing or nerve repairing. All patients were evaluated after 6 months for ankle function and wound complications. Result: Of 15 patients one was excluded from study. At 6 month ten patients got excellent score (66%) and 4 good score (26%) further ankle function. There was no wound complication at insertion site. Conclusion: This simple modification for insertion site fixation had good result in restoring ankle function whiles eliminated the possibility of plantar pressure sores caused by fixation knop.