Follow-up of tibialis posterior transfer surgery (TPT) for drop-foot in leprosy.

Prevention of Disability (POD) service needs to be expanded for future reducing the leprosy burden. Tibialis Posterior Transfer Surgery (TPT) is an established procedure and relatively easy to do at district level general hospitals. It can protect further damages of affected foot and consequently reduce patient's social burden as well. Totally 70 TPT surgeries were done during a joint project of JICA on leprosy control and basic health service in Myanmar for training purpose (Jan/2002-Jan/2006). A follow-up assessment was done for exploring the effectiveness of foot drop surgery, in Nov/2006 at 9-selected townships in Mid-Myanmar. 33 cases (Male 22, Female 11) were reviewed and the mean of follow up period was 29.1 months (SD=7.1, 10-48 months). Total results were; good: 25 cases (76%), fair: 4 cases (12%) and poor: 4 cases (12%). In good and fair cases, patients were satisfied with the results and TPT improved the QOL of patients. In almost all cases (32/33, 97%) after TPT, patients are free from plantar ulcer. Most serious complication of operation (4 cases, 12%) identified was inversion deformity due to loosed tension of lateral tail of grafted TP tendon sutured to Extensor Digitorum Longus. From the results of TPT surgery follow-up, it can benefit much to the patients if resources permit to make it as a routine service in more places.