• T Kremer, K Riedel, G Germann, C Heitmann, and M Sauerbier.
• BG-Unfallklinik Ludwigshafen, Hand-, Plastische und Rekonstruktive Chirurgie, Schwerbrandverletztenzentrum, Plastische und Handchirurgie, Universität Heidelberg, Ludwigshafen. remrksa@aol.com
• Handchir Mikrochir Plast Chir. 2011 Apr 1;43(2):95-101.

PurposePatients with persistent peroneal palsy may require treatment for gait disturbances if conservative treatment is not tolerated. Transfer of the tibialis posterior tendon can restore foot extension and improve the patients gait pattern.Patients And MethodsRetrospective analysis (mean follow-up 40.8 months) of 13 patients. (7♀, 6♂; 1998-2005) after tibialis posterior tendon transfer through the interosseous membrane to the tibialis anterior and peroneus longus tendons. Evaluation focussed on hospitalisation periods, perioperative morbidity, functional outcome (range of motion, strength, pain and gait), return to work rate and self assessment with the Funktionsfragebogen Hannover (FFbH).Results7 iatrogenic, 5 posttraumatic and 1 congenital peroneal palsy were treated. The patients presented after an average of 8.3 months (hospitalisation 11 days). Perioperative morbidity was 38.4% (15.4% reoperation rate). The mean active range of motion of the ankle was 3°/0°/56° (extension/flexion), the average strength was 3 (MRC) and pain was 4 (visual analogue scale 1-10). 12 patients were evaluated with normal or improved gait pattern without ortheses. The mean FFbH score was 70.9%.ConclusionIf conservative treatment for peroneal palsy fails to improve functional outcome tendon transfers such as the tibialis posterior tendon transfer are a considerable treatment option. However, significant morbidity rates have to be anticipated. Consecutive patients should be referred in good time to specialised units.© Georg Thieme Verlag KG Stuttgart · New York.

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