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S.P.L.A.T.T.

Posted by GT on 3/06/05 at 06:55 (170559)

Split anterior tibial tendon transfer. Has anyone here had this surgery done? I would apreciate any info you could give me as my Pod. has recommended that I undergo this procedure. It is supposed to help correct my foot drop which is caused by CMT. Thanks!

Re: S.P.L.A.T.T.

Mike C on 3/07/05 at 17:28 (170642)

If you truely have C.M.T your tibialis anterior as well as your peroneals are weak. In such a case clawing of the toes results from recruitment of the extensor digitorum longus to aid the weak dorsiflexor (tibialis anterior). A splatt will not help as the tibialis is weak and in itself needs to be augmented. Even if it is only the peroneals that are affected a splatt is not indicated. The priciple is to restore function, not rob Peter to pay Paul. Correction of C.M.T. manifestations in the foot is complex. I feel this should not be attempted by individuals who do not have extensive experience with such a complex deformity.

Re: S.P.L.A.T.T.

GT on 3/09/05 at 21:13 (170844)

I won't pretend I understood most of what you said, but I guess I get the idea you don't feel this will help much. Maybe I'm wrong, but can't cmt be manifested in different individuals different ways? My dorsiflexor seems to be relatively strong. My peroneals seem to be all that is affected by the cmt. What other possibilities do I have to correct the foot drop(quite pronounced) so I don't have future problems in the lower leg and knee area? Thanks again.

Re: S.P.L.A.T.T.

Mike C on 3/10/05 at 06:56 (170858)

Yes, the manifestions can differ form individual to individual. For isolated peroneal weakness I would recommend a transfer of the tendon that flexes the last joint of the big toe. This is more consistent funciton-wise, less risk of scar formation causing stiffness and it is unaffected by the CMT process.
Give me a little more information regarding what's bothering you, what your foot looks like and what your ankle range of motion is...if you don't mind.