Causes and risk factors
Nerve or muscle injury is the main cause of foot drop along with anatomical deformities. Any brain or spinal cord injury like multiple sclerosis or growth of some tumor in the spinal region causing compression of the nerve can cause foot drop. Neurological cause is the commonest in which peritoneal nerve which is supplied to lower leg and foot is affected or injured. Diabetes, polio or Charcot-Marie-Tooth disease, muscular dystrophy, multiple sclerosis, stroke, cerebral palsy is some of the diseases which can cause foot drop. Post surgical complications specially after hip replacement surgery or knee replacement orthoplasty are cause of concerned to the orthopedic surgeons, which can lead to foot drop. Often people with habit of sleeping and sitting cross legged are pre disposed to injury of peritoneal nerve thus increasing the chances of foot drop.
Clinical presentation:
Foot drop can be permanent or temporary depending upon the cause and it’s extend. Foot drop is primarily a gait disorder. The patient faces difficulty in walking. Drags the foot while walking with compensating knee mobility raising the thigh for flexion at hip. Often patient walks with a gait as if climbing stair case called ‘Steppage gait’. Patient lifts the foot takes the step bangs on the ground with force causing further ankle heel trauma. Associate symptoms like weakness in the lower leg and foot, difficulty in flexion or raising toes is marked.
Investigations:
Diagnosis can be done on the basis of the symptoms narrated by the patients and the physical examination carried out by the orthopedic doctor. Certain investigations can be advised like X-ray of the foot, MRI scan of the brain or spinal cord or electromyography can also be advised to find out the underlying nerve affection and its extent of damage. Additional blood test for systemic diseases may be done.
Treatment:
With good treatment mode foot drop can be corrected permanently. Use of braces and splints for supporting the ankle is suggested. Physiotherapy exercises for strengthening the muscles of the leg are advised. In Cases where foot drop is caused due to nerve injury nerve stimulation therapy is required. Surgery is advised is cases where foot drop is caused due to very recent nerve injury. In severe cases ankle foot fusion (arthrosis) is done to make the foot stable.
Recent updates:
Kessler Foundation scientists have published a study showing that use of a foot drop stimulator during a task-specific movement for 4 weeks can retrain the neuromuscular system. This finding indicates that applying the foot drop stimulator as rehabilitation intervention may facilitate recovery from this common complication of stroke.
