Bridle Procedure for the Treatment of Foot Drop – Extended (Feat. Dr. Johnson)

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Bridle Procedure for the Treatment of Foot Drop – Extended
Authors: Johnson JE1, Yee A2
Published: November 4, 2016

AUTHOR INFORMATION
1 Department of Orthopedic Surgery, Washington University, St. Louis, Missouri
2 Division of Plastic and Reconstructive Surgery, Washington University, St. Louis, Missouri

DISCLOSURE
No authors have a financial interest in any of the products, devices, or drugs mentioned in this production or publication.

ABSTRACT
Peroneal nerve injury is a frequent neuropathy in the lower extremity and injury to the common peroneal nerve presents with foot drop and steppage gait. This results in the functional loss of the anterior and, often, lateral compartment musculature of the leg. There has been limited success with nerve transfer for foot drop and the standard operative restoration of dorsiflexion in patients with peroneal nerve palsy is dynamic tendon transposition. The Bridle procedure for foot drop is a modification of the tibialis posterior tendon transfer that includes a tri-tendon anastomosis with the tibialis anterior and transposed peroneus longus. This procedure was designed to create balanced attachment points with the addition of these two tendons for a more even distribution of pull on the dorsum of the foot, thereby avoiding a varus or valgus deformity from tendon overpull. This modification often avoids the need for a triple arthrodesis or other procedure to stabilize the foot in neutral. Also, many patients complain of “ankle instability” in addition to the lack of active ankle dorsiflexion. The two additional attachment points of the transfer improves the stability of the ankle in the coronal plane. In this case, a 65-year-old female presented with bilateral lower extremity neuropathy and has a complicated and unusual history. She previously underwent a L4-5 fusion and unfortunately continued to have progressive motor weakness in both lower extremities. Electrodiagnostic studies indicated a severe right peroneal neuropathy without residual or recurrent lumbar radiculopathy and with no fibrillations or motor unit potentials. On clinical examination, she had a foot drop gait with MRC 5/5 motor strength in the tibial-innervated muscles, which included the posterior tibialis muscle, but 0/5 anterior compartment and 3/5 lateral compartment strength. The patient was managed with a Bridle procedure for treatment of right foot drop. This video demonstrates the technical nuisances of this procedure, however does not include specifics for gastrocnemius/soleus lengthening as the patient passed the Silfverskiold’s Test for contractures that are typical in patients with foot drop.

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Comments

sarosh ismail says:

Very thoroughly explained 👍

Nuzel shareef says:

Meta 5years ke bachche ku ye 3years SE problem hai motor and sensory nerve conduction study of bilateral common peroneal,tibial,sural and superficial peroneal nerves, kya ye opretio ke bina theek ho sakta hai plz reply me

pk sharma says:

Hlo sir please contact no.

Gazi Mohammad Hasan Firoz says:

Assalamu alaikum, Sir, thanks a lot. I am expecting more videos. Nice demonstration.

Dr Vivek Ambedkar - Cuttis Plastic Surgery Center says:

I am doing same tendon transfer surgery

Ariel Dimatera says:

How can i comunacate to you sir

Ariel Dimatera says:

I have a footdrop now can i back normal sir?

hamza loucif says:

I saw the procedur Yesterday and performed it to day , very good video thanks

Darkpsyde says:

This was amazing to watch. Thank you for the upload

A1 Gamezone says:

I. Am from india sir 😓😓😓

A1 Gamezone says:

Please tricmnet my food drop

A1 Gamezone says:

I. Am food drop. Pesant

Trigga holic says:

Where can I get this done and what’s the cost ?

martin emerald says:

Very well explained Dr
Thank you

Babli Anganwadi says:

Sir my foot drop please help me please send me foot drop surgery doctor no

Narayan Patel says:

I have my father foot drop Rt legs.. and Lt legs I live India in Indore pls sir help pls sir contact me 9685060456 and your contact send pls sir 3 years ago.. sir I have requested sir my father is problem a washroom etc.. pls sir request ?? 🙏🙏

Master peace #U says:

Is this a ded body.no blod is come

Master peace #U says:

How can i contact u

Bassam Addas says:

great production. thanks a million

Liv Keenannn says:

I am 15 years old I have has foot drop for 5 + years and mine got a tiny bit better but hardly I recently had an mri and they found out a problem my nerve and the muscle around it thickened which is a fatty atrophy according too the doctors so there’s a chance I could get surgery so move the good muscle for the back of my leg to the part where the bad muscle is to free it up so I can gain movement back

လွမ်း သူ says:

Thanks. Very nice surgeey.

Mahesh Hosamane says:

VERY GOOD PRESENTATION

Kimberley Christman says:

Hi im Kimberley and I have for drop and I've been trying to find someone to do the tindon transfer and I found you.
I live in the deep south and I have got to wear the custom molded foot brace and it's hot and I wear it but I hate it i have to buy 2 pairs of shoes just to accommodate the brace.
Please contact me

Shaheena Moin says:

I have also a foot drop what do i do? I live in pakistan

zahid khan says:

Simply great demostration and cemera work …
All perfect..thanksss

Mike Alvarado says:

Just got the operation done by Dr. Jeff Johnson one of the best doctors they can get you up and running again so glad I found them

dr Upendragoud says:

Stupid surgery, can go for BARR technique,

AARU4046 says:

Your the best sir

zekward wax says:

Great work!

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