FOOT DROP

Foot drop, is a neurological disorder which is defined as inability to lift the forefoot due to weakness of muscles in the ankle/foot also known as the dorsiflexors. This condition may be the result of a muscular, skeletal, or nervous system problem. To develop a treatment plan for foot drop, a full evaluation and determination of the cause must be completed for each patient. Just as foot drop can have many causes, foot drop treatment can take many forms.

There are a plethora of etiologies that can cause foot drop; one of which are compressive disorders. The most common being compression of the peroneal nerve, which is located in a patients lower extremity ( hip, ankle, or leg). Foot drop may also be caused secondary to traumatic injuries to include knee/ hip dislocation, fractures, severe ankle inversions, blunt trauma. Foot drop secondary to iatrogenic causes is seen most frequently due to surgical procedures; more often secondary to protracted positioning in anesthesia, although other causes such as prolonged bed rest, splinting, and even pneumatic compression devices may cause symptoms.

Foot drop, may be partial or complete, developing acutely or over a period of days to weeks. Patients may complain of dragging their toes, problems walking or climbing stairs, or frequent falls.

When foot drop occurs due to peripheral nerve entrapment, the symptoms will differ depending on the affected nerve and site of entrapment. Foot drop caused by entrapment of the peroneal nerve may also result in decreased sensation, tingling, numbness, or burning from the lower lateral leg to the top of the foot.

Foot drop is generally a clinical diagnosis apparent from the history and physical examination. Extremity imaging is useful for ruling out fracture or other anatomic abnormalities, to help identify a likely etiology. Most patients will undergo electromyography (EMG), unless there has been an obvious traumatic nerve transection.

A number of nonsurgical treatment options are available for the management of foot drop. The approach to the patient depends upon the etiology of foot drop and the localization of the lesions. Treatment plans are individualized based upon the evaluation and diagnostic findings.