Effectiveness of Bridle procedure for correction of foot drop syndrome due to peroneal nerve neuropathy
A. A. Grigoryan,
L. G. Makinyan,
A. M. Mannanov,
Ch. Moldamyrzayev,
M. A. Imankulov,
W. M. Abu Zaalan https://doi.org/10.18019/1028-4427-2025-31-6-737-743
Abstract
Introduction Foot drop syndrome due to peroneal nerve neuropathy significantly impairs limb support and patient quality of life. The aim of this study was to evaluate the clinical effectiveness of the Bridle procedure compared to ankle arthrodesis and isolated tendon transfer.
Materials and methods A retrospective analysis of 27 patients was performed, divided into a main group (n = 14, Bridle technique) and a control group (n = 13, arthrodesis or tendon transfer). Functional outcomes were assessed using the AOFAS and VAS scales, along with rehabilitation duration, orthotic use, and complication rates. The mean follow-up period was 2.3 years.
Results The main group showed significantly better outcomes: AOFAS score improved from 38 to 82, VAS score decreased from 6.8 to 2.1, and the need for orthotic devices was reduced. In the control group, improvements were less pronounced (AOFAS: 37→65; VAS: 6.7→3.9). The complication rate was 14.3 % in the Bridle group versus 38.5 % in the control group.
Discussion The Bridle technique restores active dorsiflexion while preserving ankle mobility. Its functional and rehabilitation advantages make it preferable in cases of isolated peroneal nerve injury without severe deformities.
Conclusion The Bridle procedure is an effective joint-preserving surgical method for treating foot drop, providing superior clinical outcomes compared to alternative interventions.
About the Authors
A. A. Grigoryan
Patrice Lumumba Peoples' Friendship University of Russia
Russian Federation
Russian Federation
Artsrun A. Grigoryan — post-graduate student
Moscow
L. G. Makinyan
Patrice Lumumba Peoples' Friendship University of Russia;
VDemikhov City Clinical Hospital
Russian Federation
Russian Federation
Levon G. Makinyan — Candidate of Medical Sciences, Associate professor of the Department, Head of Department
Moscow
A. M. Mannanov
VDemikhov City Clinical Hospital
Russian Federation
Russian Federation
Albert M. Mannanov — Candidate of Medical Sciences, orthopaedic surgeon
Moscow
Ch. Moldamyrzayev
Patrice Lumumba Peoples' Friendship University of Russia
Russian Federation
Russian Federation
Chyngis Moldamyrzayev — post-graduate student
Moscow
M. A. Imankulov
Patrice Lumumba Peoples' Friendship University of Russia
Russian Federation
Russian Federation
Mikhail A. Imankulov — post-graduate student
Moscow
W. M. Abu Zaalan
Patrice Lumumba Peoples' Friendship University of Russia;
VDemikhov City Clinical Hospital
Russian Federation
Russian Federation
Wessam Mussa Abu Zaalan — post-graduate student, orthopaedic surgeon
Moscow
References
1. Ewerbeck V, Wentzensen V, Holz F, et al. Standard procedures in operative orthopedics and trauma surgery. 3rd ed. Stuttgart: Thieme; 2006:928. (in German)
2. Bowley MP, Doughty CT. Entrapment Neuropathies of the Lower Extremity. Med Clin North Am. 2019;103(2):371-382. doi: 10.1016/j.mcna.2018.10.013.
3. Golubeva YuB, Andrievskaya AO, Gorelova IK, et al. Orthopedic services as a tool of medical rehabilitation of patients with foot drop syndrome. S.S. Korsakov Journal of Neurology and Psychiatry. 2020;120(10):91-99. (In Russ.) doi: 10.17116/jnevro202012010191.
4. Khizhnikova AE, Klochkov AS, Belova NV, et al. Foot drop: causes, clinical and instrumental diagnostics, and biomechanics. Nervous Diseases. 2024;(1):22-30. (In Russ.) doi: 10.24412/2226-0757-2024-13057.
5. Nori SL, Stretanski MF. Foot Drop [Internet]. In: StatPearls. Treasure Island (FL): StatPearls Publishing; 2025. Available from: https://www.ncbi.nlm.nih.gov/books/NBK554393/.
6. Novikov AV, Antonova VA. Neuropathy of the peroneal nerve as a complication after total knee arthroplasty: characteristics of rehabilitation. N.N. Priorov Journal of Traumatology and Orthopedics. 2020;27(4):41-45. (In Russ.) doi: 10.17816/vto57137.
7. Matsumoto J, Isu T, Kim K, et al. Impact of additional treatment of paralumbar spine and peripheral nerve diseases after lumbar spine surgery. World Neurosurg. 2018;112:e778-e782. doi: 10.1016/j.wneu.2018.01.154.
8. Yarikov AV, Makeeva OA, Baytinger AV, et al. Fibular tunnel syndrome: modern principles of diagnosis and treatment. The Doctor. 2023;34(11):5-9. (In Russ.) doi:10.29296/25877305-2023-11-01.
9. García-Martínez MÁ, Montejo González JC, García-de-Lorenzo Y Mateos A, Teijeira S. Muscle weakness: Understanding the principles of myopathy and neuropathy in the critically ill patient and the management options. Clin Nutr. 2020;39(5):1331-1344. doi: 10.1016/j.clnu.2019.05.027.
10. Carolus AE, Becker M, Cuny J, et al. The Interdisciplinary Management of Foot Drop. Dtsch Arztebl Int. 2019;116(20):347-354. doi: 10.3238/arztebl.2019.0347.
11. Desy NM, Wang H, Elshiekh MAI, et al. Intraneural ganglion cysts: a systematic review and reinterpretation of the world's literature. J Neurosurg. 2016;125(3):615-630. doi: 10.3171/2015.9.JNS141368.
12. Kretschmer T, Antoniadis G, Braun V, et al. Evaluation of iatrogenic lesions in 722 surgically treated cases of peripheral nerve trauma. J Neurosurg. 2001;94(6):905-912. doi: 10.3171/jns.2001.94.6.0905.
13. Huckhagel T, Nüchtern J, Regelsberger J, et al. Nerve trauma of the lower extremity: evaluation of 60,422 leg injured patients from the TraumaRegister DGU® between 2002 and 2015. Scand J Trauma Resusc Emerg Med. 2018;26(1):40. doi: 10.1186/s13049-018-0502-5.
14. Westhout FD, Paré LS, Linskey ME. Central causes of foot drop: rare and underappreciated differential diagnoses. J Spinal Cord Med. 2007;30(1):62-66. doi: 10.1080/10790268.2007.11753915.
15. Nedosekina MP. Acute neuropathy of the left common peroneal nerve in neurological practice: a clinical case. Brain Universe. 2021;3(1[8]):45-46. (In Russ.)
16. Matejcik V, Penzesova G. Surgery of the peripheral nerves. Bratisl Lek Listy. 2006;107(3):89-92.
17. Giuffre JL, Bishop AT, Spinner RJ, et al. Partial tibial nerve transfer to the tibialis anterior motor branch to treat peroneal nerve injury after knee trauma. Clin Orthop Relat Res. 2012;470(3):779-790. doi: 10.1007/s11999-011-1924-9.
18. Poage C, Roth C, Scott B. Peroneal nerve palsy: evaluation and management. J Am Acad Orthop Surg. 2016 Jan;24(1):1-10. doi: 10.5435/JAAOS-D-14-00420.
19. Bao B, Wei H, Zhu H, Zheng X. Transfer of Soleus Muscular Branch of Tibial Nerve to Deep Fibular Nerve to Repair Foot Drop After Common Peroneal Nerve Injury: A Retrospective Study. Front Neurol. 2022;13:745746. doi: 10.3389/fneur.2022.745746.
20. Merkulov VN, Imyarov ShD, Dorokhin AI. Tendomuscular transposition in old peroneal nerve injuries in children. Pediatric Surgery. 2014;(3):20-22. (In Russ.)
21. Takaishi Y, Okada M, Fujiwara D, et al. Surgical Results of Lumbar Degenerative Disease with Foot Drop. No Shinkei Geka. 2019;47(8):851-857. (In Jap) doi: 10.11477/mf.1436204036.
22. Vang Zh, Akhtyamov IF, Ziatdinov BG, Faizrakhmanova GM. Ankle arthrodesis: realities and prospects against the background of new technologies. Literature Review. Bulletin of Rehabilitation Medicine. 2022; 21(2): 115-126. (In Russ.) doi: 10.38025/2078-1962-2022-21-2-115-126.
23. Karapinar H, Sener M, Kazimoglu C, Akgun U. Arthrodesis of neuropathic ankle joint by Ilizarov fixator in diabetic patients. J Am Podiatr Med Assoc. 2009;99(1):42-48. doi: 10.7547/0980042.
24. Bek D, Demiralp B, Kürklü M, et al. Ankle arthrodesis using an Ilizarov external fixator in patients wounded by landmines and gunshots. Foot Ankle Int. 2008;29(2):178-184. doi: 10.3113/FAI.2008.0178.
25. Matsakyan AM, Shirmazanyan AG, Gorochovodatsky AV. Operations on the tendon of the posterior tibial muscle in the treatment of a static flat-valgus deformation. Vestnik of the Smolensk State Medical Academy. 2017;16(4):168-177. (In Russ.)
26. Johnson JE, Paxton ES, Lippe J, et al. Outcomes of the Bridle Procedure for the Treatment of Foot Drop. Foot Ankle Int. 2015;36(11):1287-1296. doi: 10.1177/1071100715593146.
27. McCall RE, Frederick HA, McCluskey GM, Riordan DC. The Bridle procedure: a new treatment for equinus and equinovarus deformities in children. J Pediatr Orthop. 1991;11(1):83-89.
28. Hastings MK, Sinacore DR, Woodburn J, et al. Kinetics and kinematics after the Bridle procedure for treatment of traumatic foot drop. Clin Biomech (Bristol). 2013;28(5):555-561. doi: 10.1016/j.clinbiomech.2013.04.008.
29. Rodriguez RP. The Bridle procedure in the treatment of paralysis of the foot. Foot Ankle. 1992;13(2):63-69. doi: 10.1177/107110079201300203.
Review
For citations:
Grigoryan A.A., Makinyan L.G., Mannanov A.M., Moldamyrzayev Ch., Imankulov M.A., Zaalan W.M. Effectiveness of Bridle procedure for correction of foot drop syndrome due to peroneal nerve neuropathy. Genij Ortopedii. 2025;31(6):737-743. https://doi.org/10.18019/1028-4427-2025-31-6-737-743
Views:
453
JATS XML
Email this article 