Back to Search
Start Over
Strength of Interference Screw Fixation to Cuboid vs Pulvertaft Weave to Peroneus Brevis for Tibialis Posterior Tendon Transfer for Foot Drop
- Source :
- Foot & Ankle International. 39:858-864
- Publication Year :
- 2018
- Publisher :
- SAGE Publications, 2018.
-
Abstract
- Background: Tibialis posterior (TP) tendon transfer is an effective treatment for foot drop. Currently, standard practice is to immobilize the ankle in a cast for 6 weeks nonweightbearing, risking postoperative stiffness. To assess whether early active dorsiflexion and protected weightbearing could be safe, the current study assessed tendon displacement under cyclic loading and load to failure, comparing the Pulvertaft weave (PW) to interference screw fixation (ISF) in a cadaveric foot model. Methods: Twenty-four cadaveric ankles had TP tendon transfer performed, 12 with the PW technique and 12 with ISF to the cuboid. The TP tendon was cycled 1000 times at 50 to 150 N and then loaded to failure in a materials testing machine. Tendon displacement at the insertion site was recorded every 100 cycles. An independent t test and 2-way analysis of variance were performed to compare techniques, with a significance level of P < .05. Results: Mean tendon displacement was similar in the PW group (2.9 ± 2.5 mm [mean ± SD]) compared with the ISF group (2.4 ± 1.1 mm), P = .35. One specimen in the ISF group failed early by tendon pullout. None of the PW group failed early, although displacement of 8.9 mm was observed in 1 specimen. Mean load to failure was 419.1 ± 82.6 N in the PW group in comparison to 499.4 ± 109.6 N in the ISF group, P = .06. Conclusion: For TP tendon transfer, ISF and PW techniques were comparable, with no differences in tendon displacement after cyclical loading or load to failure. Greater variability was observed in the PW group, suggesting it may be a less reliable technique. Clinical Relevance: The results indicate that early active dorsiflexion and protected weightbearing may be safe for clinical evaluation, with potential benefits for the patient compared with cast immobilization.
- Subjects :
- Foot drop
DIGITORUM LONGUS TRANSFER
medicine.medical_treatment
Bone Screws
SUTURE ANCHOR
HINDFOOT
Tendons
0302 clinical medicine
0903 Biomedical Engineering
Orthopedics and Sports Medicine
ANTERIOR TENDON
1106 Human Movement And Sports Science
CRUCIATE LIGAMENT RECONSTRUCTION
Orthodontics
030222 orthopedics
Cuboid
musculoskeletal system
Pulvertaft weave
Biomechanical Phenomena
tendon transfer
medicine.anatomical_structure
medicine.symptom
Life Sciences & Biomedicine
tibialis posterior
medicine.medical_specialty
Supination
rehabilitation
03 medical and health sciences
Tendon transfer
Cadaver
Deformity
medicine
Humans
FOREFOOT
Muscle, Skeletal
Peroneal Neuropathies
Science & Technology
Tibia
business.industry
Forefoot
DIAMETER
ANKLE
1103 Clinical Sciences
Tarsal Bones
foot drop
030229 sport sciences
Orthopedics
IMMOBILIZATION
Orthopedic surgery
interference screw
Surgery
Ankle
DEFORMITY
Peroneus brevis
business
Subjects
Details
- ISSN :
- 19447876 and 10711007
- Volume :
- 39
- Database :
- OpenAIRE
- Journal :
- Foot & Ankle International
- Accession number :
- edsair.doi.dedup.....0e9ab6f76688cfd45a4b34e811fe3a25