Tibialis Posterior & FDL Tendon Transfers for Foot Drop

INTRODUCTION 2 WEEK POST-OP APPOINTMENT

• Review by nurse & removal of cast, dressings and
Injury to the common peroneal nerve can result in foot sutures
deformity and foot drop. Tibialis posterior tendon and • Change to VACOcast surgical boot
flexor digitorum longus tendon transfers aim to restore
foot func<on, reduce discomfort and produce a more WEEKS 3-6
normal way of walking. • Surgical boot on at ALL <mes, including in bed,
except for physio/exercises & showers
(seated with shower chair)
THE SURGERY • Elevate foot when res<ng
• Daily scar massage from 3 weeks post-op
Tibialis posterior and FDL tendon transfer surgery • Con<nue Aspirin and Vitamin C
involves a number of steps: • Physiotherapy review (arrange first appointment for
• General anaesthe<c and IV an<bio<cs 2-5 days a_er the 2-week post-op check)
• Tourniquet around the thigh • PHYSIOTHERAPY:
• Lengthening of the Achilles tendon Commence gentle ac<ve and passive ankle, midfoot
• Mul<ple incisions around the foot and ankle and forefoot ROM exercises
• Exposure and harves<ng of the tendons Commence par<al weightbearing, and progress up
• Tendon transfers and inser<on into bone using to full weightbearing at 6 weeks post-op if tolerated
suture anchors or screws - in surgical boot for all weightbearing
• Closure of incisions with sutures General upper body, core, hip and knee exercises
• Local anaesthe<c block
• Plaster cast 6 WEEK POST-OP APPOINTMENT
• Review by Dr Zilko
GUIDELINES FOR POST-OP RECOVERY WEEKS 7-16
• PHYSIOTHERAPY:
HOSPITAL ADMISSION Transi<on out of boot into normal suppor<ve shoes
• In hospital post-op for 1 night Neuromuscular re-training
• IV an<bio<cs and Clexane injec<ons Gait re-training
Exercise bicycle/ellip<cal trainer
FIRST 2 WEEKS Con<nue lower limb strength and condi<oning
• Elevate foot and rest
• Strictly NON-WEIGHTBEARING in cast FROM 16 WEEKS
• Mobilise with knee scooter/crutches/frame • PHYSIOTHERAPY:
• Cast and dressings to stay dry and intact Work-specific or sport-specific training
• Strong painkillers as required Safe to commence open-chain impact/running if
• Aspirin 100mg and Vitamin C 1g per day tendon transfers well healed
• An<bio<cs for 5 days
• Wiggle toes to encourage circula<on Full recovery is usually 9-12 months.

Every pa)ent’s recovery is individual and depends on the

severity of the injury and complexity of the surgery.

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Dr Simon Zilko ABN 35 192 898 398 
 Wexford Medical Centre
 Hollywood Medical Centre

P 08 6166 3779 F 08 6316 3316 
 Suite 64, Level 4,
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E admin@drsimonzilko.com.au 
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www.drsimonzilko.com.au Murdoch WA 6150 Nedlands WA 6009