34-2 Foot Drop



Several years ago, a valued colleague encouraged me to attend a peripheral nerve surgery course presented by The Association of Extremity Nerve Surgeons (AENS). This intensive, three-day course focused on the diagnosis and treatment of lower extremity peripheral nerve pathologies. Among other lessons, the faculty at the course taught podiatric and allopathic surgeons how to perform thorough and nuanced neurological examinations and novel surgical techniques for lower extremity nerve entrapments. They also introduced common fibular nerve (CFN) decompressions as a treatment for foot drop.

Foot drop occurs when a patient is unable to dorsiflex the foot and the toes. The causes are varied, but most often, the foot drop occurs when a nerve (L5 spinal level or CFN) is compressed and ceases to send input to the muscles in the leg, resulting in sensory and motor deficits.

In this issue, Dr. James Wilton provides us with an insightful exploration of the pathophysiology, diagnosis, and treatments for foot drop caused by compression of the CFN. In one of our audio lectures, Dr. Julie Abboud (the president of AENS) shares her expertise regarding the surgical decompression of the CFN in the lower leg. In our other lecture, Dr. Steven Shannon addresses cases that require tendon transfers and ankle fusions.

The commentaries in this issue are written by my podiatric surgery colleagues from around the United States, as well as by my multidisciplinary colleagues at the CPL Michael J. Crescenz VA Medical Center in Philadelphia.  All of the commentaries address the significance of a timely diagnosis and pursuing a treatment that will optimize each patient’s quality of life.

Since attending my first peripheral nerve surgery course I have attended other AENS seminars, and I am consistently fascinated by the complexity and elegance of nerve pathologies and the innovative surgeries that exist for their treatment. I hope that this edition of FAQ brings new insights into your practice and encourages further education into nerve pathologies.

Marija Ugrinich, DPM, FACFAS



In this Issue

  • FEATURE ARTICLE: Evaluating and Treating Drop Foot Deformity
    James P. Wilton, DPM
    • MRI of Foot Drop: How We Do It
      Commentary by Alexander T. Ruutiainen, MD
    • Surgical Treatment of Foot Drop: Patient Evaluation and Peripheral Nerve Treatment Options
      Commentary by Sarah A. Spizzirri, DPM
    • The Interdisciplinary Management of Foot Drop
      Commentary by Kittra T. Owens, DPM, FACFAS, FACPM
    • Identifying Common Peroneal Neuropathy before Foot Drop
      Commentary by Jacob Wynes, DPM, MS, FACFAS
    • Investigating the Effects of Conventional Thermoplastic Ankle-Foot and the Neoprene Ankle-Foot Orthoses on the Kinetics and Kinematics of Gait in People with Foot Drop following Traumatic Injury of the Peroneal Nerve: A Pilot Study
      Commentary by Ronnell Upshur, CPO
    • The Efficiency of Mirror Therapy on Drop Foot in Multiple Sclerosis Patients
      Commentary by Wynn Rajan, DPT
    • Tendon Transfer in Foot Drop: A Systematic Review
      Commentary by Steven Shannon, DPM, FACFAS
    • Peroneal Neuropathy and Bariatric Surgery: Untying the Knot
      Commentary by Marija Ugrinich, DPM, FACFAS
    • Clinical Outcomes after Neurolysis for the Treatment of Peroneal Nerve Palsy: A Systematic Review and Meta-Analysis
      Commentary by Asim A.Z. Raja, DPM
    • Does Lower Extremity Nerve Decompression Surgery Improve Quality of Life?C
      Commentary by Arwa El-Sayed, DPM
  • AUDIO LECTURE 1: Tendon Transfer Procedures Available for Drop Foot Deformity
    Steven Shannon, DPM, FACFAS
  • AUDIO LECTURE 2: Foot Drop and Common Fibular Nerve Compression
    Julie Abboud, DPM, MS, FAENS