How is foot drop managed when the cause is dorsiflexor injury?

Updated: Mar 23, 2020
  • Author: James W Pritchett, MD; Chief Editor: Vinod K Panchbhavi, MD, FACS  more...
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Answer

With dorsiflexor injury due to laceration or contusion, both cause and effect are readily apparent on clinical examination. (See the video below.) A young healthy patient or an active healthy elderly patient usually benefits from surgical repair of the injury.

Gait of patient with foot drop.

If the patient develops a degenerative rupture of the tibialis anterior, foot drop may be observed, but the cause may not be immediately apparent. Such a patient is often an elderly man who suffers a minor trauma with the foot in plantarflexion. The patient stands with the foot everted and has some loss of dorsiflexion when attempting to heel-walk. The degree of foot drop varies, depending on the time elapsed since the rupture.

Active function in the other muscles innervated by the deep and superficial branches of the peroneal nerve essentially rules out the possibility of a peripheral neuropathy. Functional recovery is achieved over time and is aided by bracing of the affected ankle. Surgery may not be required in this situation.


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