Systematic review and meta-analysis demonstrates functional recovery following tendon transfer for foot drop, indicating surgical viability despite variable nerve repair outcomes.
Key Points
Synthesize evidence on functional outcomes across different reconstructive surgical strategies for foot drop secondary to common peroneal nerve injury.
Systematic review following PRISMA guidelines searching MEDLINE, Embase, and LILACS from inception through April 11, 2026.
Included 19 observational studies and case series assessing neurolysis, nerve repair, nerve transfer, tendon transfer, and combined approaches.
Conducted a random-effects meta-analysis of proportions for tendon-transfer studies assessing functional dorsiflexion.
Tendon-transfer procedures yielded functional recovery in 70% to 90% of patients, whereas neurolysis, nerve repair, and nerve transfer showed more variable results.
Meta-analysis of 7 tendon-transfer studies (n = 139) demonstrated a pooled functional dorsiflexion rate of 76.4% (95% CI: 67.2–83.7; I² = 11.6%).
Certainty of evidence was rated as low to very low across all surgical intervention categories due to observational designs and methodological limitations.