Q: I am a 29 years old male. I have a foot drop due to deep peroneal injury a month ago. I consulted a few doctors but they were unable to give me a good solution. They adviced pac for peroneal nerve repair and tendon transfer. I am not sure of their suggestion. Please advise.

A:Deep peroneal nerve injury is an injury that is difficult to treat by nerve repair. This is because of peculiarities of the nerve itself. As a result even after repair recovery of nerve function may not be good. However, if there is established nerve injury reconstruction can be done by tendon transfer. For this a tendon must be available for transfer (usually tendon of tibialis posterior). Normally this tendon belongs to another group that does the opposite function of the muscle supplied by deep peroneal nerve. Therefore, the functional integration is difficult. Even if function is not normal the patient has improvement in foot drop. At times some surgeons like to combine this with what is called a foot stabilization procedure (triple arthrodesis). In this some of the small joints of the foot are fused so that the transfer tendon can function more efficiently. Where is it done? This depends on where you are living. I recommend this should be done in places where routine surgeries for tendon transfers are being done. This will usually be a centre where treatment of paralytic limbs is common and in large surgical departments with high volume of such surgeries, usually in medical colleges. The best centers are the ones which take care of leprosy patients as this kind of paralysis is common in them.