TY - JOUR
T1 - Bridle Procedure Combined With a Subtalar Implant
T2 - A Case Series and Review of the Literature
AU - Flynn, James
AU - Wade, Allison
AU - Bustillo, Jorge
AU - Juliano, Paul
N1 - Publisher Copyright:
© 2014 The Author(s).
PY - 2015/2/21
Y1 - 2015/2/21
N2 - Background. The bridle procedure is a tritendon anastomosis between the tibialis posterior, peroneus longus, and tibialis anterior, utilized in the treatment of drop foot. Concerned about the potential for acquired flatfoot deformity following the bridle procedure, the authors hypothesized that placing a sinus tarsi implant would prevent this potential sequela. Materials and Methods. Over a 10-year period, 15 patients (16 feet) were treated with a bridle procedure for drop foot, and 9 of these feet also had a subtalar arthroereisis implanted; 8 patients (9 feet) positively responded to requests for long-term follow-up evaluation and returned for subjective evaluation with the American Orthopaedic Foot and Ankle Society (AOFAS) Hindfoot Scale and Short Form (SF)-36 forms and objective clinical and radiographic measurements. Results. At an average follow-up of 61 months, the 8 patients (9 feet) who returned for long-term evaluation maintained a plantigrade foot, were able to dorsiflex above neutral both actively and passively, and did not develop a flatfoot deformity at long-term follow-up. There were no significant differences between those who had a sinus tarsi implant (6 feet) and those who did not (3 feet). Although 7 of the 9 feet evaluated in this study wore a brace preoperatively, none continued to use a brace after surgery. The major complaints were occasional pain at the subtalar arthroereisis site and a feeling that the great toe was dragging. Conclusion. The bridle procedure provided excellent outcomes in patients with drop foot, with patients achieving long-term success in being free from brace wear. The ability to actively dorsiflex the foot during gait was also restored, reestablishing a normal heel-to-toe gait pattern.Levels of Evidence: Therapeutic, Level IV: Case series.
AB - Background. The bridle procedure is a tritendon anastomosis between the tibialis posterior, peroneus longus, and tibialis anterior, utilized in the treatment of drop foot. Concerned about the potential for acquired flatfoot deformity following the bridle procedure, the authors hypothesized that placing a sinus tarsi implant would prevent this potential sequela. Materials and Methods. Over a 10-year period, 15 patients (16 feet) were treated with a bridle procedure for drop foot, and 9 of these feet also had a subtalar arthroereisis implanted; 8 patients (9 feet) positively responded to requests for long-term follow-up evaluation and returned for subjective evaluation with the American Orthopaedic Foot and Ankle Society (AOFAS) Hindfoot Scale and Short Form (SF)-36 forms and objective clinical and radiographic measurements. Results. At an average follow-up of 61 months, the 8 patients (9 feet) who returned for long-term evaluation maintained a plantigrade foot, were able to dorsiflex above neutral both actively and passively, and did not develop a flatfoot deformity at long-term follow-up. There were no significant differences between those who had a sinus tarsi implant (6 feet) and those who did not (3 feet). Although 7 of the 9 feet evaluated in this study wore a brace preoperatively, none continued to use a brace after surgery. The major complaints were occasional pain at the subtalar arthroereisis site and a feeling that the great toe was dragging. Conclusion. The bridle procedure provided excellent outcomes in patients with drop foot, with patients achieving long-term success in being free from brace wear. The ability to actively dorsiflex the foot during gait was also restored, reestablishing a normal heel-to-toe gait pattern.Levels of Evidence: Therapeutic, Level IV: Case series.
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U2 - 10.1177/1938640014548319
DO - 10.1177/1938640014548319
M3 - Article
C2 - 25156098
AN - SCOPUS:84921369147
VL - 8
SP - 29
EP - 35
JO - Foot and Ankle Specialist
JF - Foot and Ankle Specialist
SN - 1938-6400
IS - 1
ER -