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Foot Drop: Clinical Features

Foot drop is caused by weakness of the muscles that lift the front of the foot. This causes an exaggerated stepping gait to avoid dragging the foot. It can result from injury or compression of the peroneal nerve or dorsiflexor muscles, or neurological issues like sciatic nerve damage. Initial exams depend on suspected cause, and may include x-rays, ultrasound, or MRI to identify injuries or masses. EMG can also help identify nerve issues. Treatment focuses on the underlying cause, like glucose control for diabetics or nerve stimulation after stroke, but ankle braces are often used if nerve function cannot be restored.

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Shaheryar Hasan
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43 views1 page

Foot Drop: Clinical Features

Foot drop is caused by weakness of the muscles that lift the front of the foot. This causes an exaggerated stepping gait to avoid dragging the foot. It can result from injury or compression of the peroneal nerve or dorsiflexor muscles, or neurological issues like sciatic nerve damage. Initial exams depend on suspected cause, and may include x-rays, ultrasound, or MRI to identify injuries or masses. EMG can also help identify nerve issues. Treatment focuses on the underlying cause, like glucose control for diabetics or nerve stimulation after stroke, but ankle braces are often used if nerve function cannot be restored.

Uploaded by

Shaheryar Hasan
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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Foot drop 

  
Clinical features: 
Foot drop is a clinical manifestation of weakness of muscles responsible for ankle and toe 
dorsiflexion. If these muscles become weak or paralysed, patient presents with a steppage gait. 
On an effort to raise the foot from the ground, the patient has to perform exaggerated flexion of 
the hip and knee in order to stop the foot from touching the ground. This exaggerated flexion 
also helps in heel strike when the force exerted on the foot is more than that of the body. This 
type of gait classically indicates foot drop. The patient may also present with pain on passive 
stretching­ an indication of compartment syndrome. 
  
Initial investigations: 
In a patient presenting with foot drop, investigation done are largely dependant upon the 
suspected diagnosis. In case of direct trauma, radiography of the leg must be done to rule out 
any bone or soft tissue damage. 
When a patient presents with unilateral foot drop of acute onset, without a history of trauma, 
metabolic profile should be done to rule out diabetes, toxicity due to alcohol intake or any other 
substance. Ultrasonography is done in cases of patient with hip or knee orthosis. MRI is 
performed to rule out mass lesions that may be compressing the perineal nerve. EMG is useful 
in some cases. 
  
Underlying pathology: 
Any pathology in either the dorsiflexors of the foot, or the peroneal nerve can result in foot drop. 
Following are some of them: 
●​ Direct injury causing laceration of dorsiflexors of foot 
     ​

●​ Anterior tibial tendon rupture 
     ​

●​ Anterior compartment syndrome or deep posterior compartment syndrome 
     ​

●​ Neurological causes include mononeuropathy of peroneal nerve or sciatic nerve, 
     ​

lumbosacral pathology, motor neuron disease, cerebral lesions etc. 
●​ Habit of crossing leg (behavioural) 
     ​

●​ Combination of different pathologies 
     ​

  
Common treatment: 
The first priority should always be pain management. Management of foot drop is, 
predominantly, aimed to treat the underlying pathology. In diabetics, glucose levels are 
maintained and supplementation of Vit B complex is administered where vitamin deficiency is 
suspected. In stroke patients, peroneal nerve stimulation is done to restore function, whereas, 
cases of direct trauma to the nerve, benefit from restoration of nerve function via surgery. In 
cases where surgical intervention fails, Ankle Foot Orthosis is used. 
 

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