Medical experts are always looking for new and improved ways to treat complex foot conditions, and it appears they may have found a better way of tackling Charcot-Marie-Tooth disease, a condition that can lead to the troublesome condition foot drop. The study examined how tendon transfer surgery could help prevent the onset of foot drop in patients with CMT. Below, we take a closer look at the results.
Charcot-Marie-Tooth Study
CMT is a medical condition that typically leads to deformities in the feet and toes due to muscle imbalance in the area. Foot drop, a condition categorized by the dragging of one foot as a person walks, often develops in patients with CMT due to the muscle paralysis and weakness in the muscles below the knee.
However, instead of relying on the weakened muscles to help with walking, doctors reviewed studies and found that two tendons – the extensor hallucis longus (EHL) and the extensor digitorum longus (EDL) – also play a role in a healthy gait. By transferring healthy tendons into the area, they believed they could shift the mechanical force off the degenerative tissue affected by CMT.
“One such strategy may be the transfer of the EHL and EDL tendons — tissue that attaches muscle to bone, thereby transmitting the mechanical force of muscle contraction to the bones — into the midfoot or forefoot,” the authors wrote.
With the help of some healthy cadavers, researchers were able to put that belief to the test. They performed eight tendon transfers to healthy patients with CMT. Patients were tested before and after the procedure, and doctors noted a large increase in ankle dorsiflexion after the procedure. Ankle dorsiflexion involves the backward bending and contracting of the foot when a person walks, an action that proves difficult for many patients with CMT.
Researchers also found that the procedure also increased toe extension and helped to minimize toe clawing, but questions still remain. Most notably, researchers want to learn more about the optimal site for tendon transfer during the procedure.
“EHL and EDL transfers can be used not just for the treatment of claw toes, but also to significantly augment ankle dorsiflexion power in a CMT patient with drop foot,” researchers concluded.
Any time we advance our medical understanding of how to best help our patients, it’s a step towards ridding people of ailments that caused problems in the past. Let’s hope researchers continue to further their understanding of this surgery and how to best prevent cases of foot drop in patients with CMT.
