Foot Drop

foot-treatment Foot drop is condition where the patient is unable to life the front part of their foot.

To compensate the thigh is often lifted a lot higher than normal to ensure that the toes clear the ground.

Left untreated the patient is always at risk of a trip and fall.

Causes

The sciatic nerve starts in the buttocks and runs down the back of the hip and thigh into the lower leg. Close to the hip joint the peroneal nerve branches off. After wrapping itself around the knee it attaches to the muscles responsible for lifting the foot and toes.

Both the sciatic nerve and the peroneal nerve can be injured during hip surgery.

In rare cases the nerve may be compressed by one of the retractors used but normally it is a result of the nerve being stretched whilst the leg is moved about during surgery.

Having foot drop makes walking very difficult; the front of the foot can't be lifted and drags along the floor. This is likely to result in trips and falls.

Who Is At Risk?

The highest risk patients are those who are undergoing revision work or are having a hip replacement following a hip fracture.

Symptoms

Symptoms may include: -
  • Difficulty lifting the front part of your foot
  • Dragging the foot when you walk
  • Slapping the foot down on every step
  • Lifting the thigh higher than normal when you walk (steppage gait)
  • Numbness, pain or weakness in the affected foot

Diagnosis

The most simple test is to simply to ask the patient to raise their toes.

An MRI (magnetic resonance imaging) may be used to show up damage to the area surrounding the nerve.

An EMG (electromyography) can pinpoint where damage has occurred and how severe it is and from this a prognosis can be worked out.

Drop Foot Treatment

In some cases the foot drop will heal itself with time and with exercises

AFO There are a range of different braces available. These are called AFOs or ankle-foot orthotics (see picture). Some of these have spring-loaded mechanisms which work to raise the foot as it comes off the ground, others prevent the foot from pointing to the ground and yet others are simply a solid brace.

Stimulation of the peroneal nerve is a newer treatment which some patients are finding useful. Stimulating the nerve causes the foot to be raised during walking.

It is highly probably that specific exercises will be prescribed.




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