Beyond Drop Foot: A Spectrum-Based surgical Approach to Flaccid Foot Paralysis

Document Type : EDITORIAL

Author

Orthopedic Research Center, Mashhad University of Medical Sciences, Mashhad, Iran

10.22038/abjs.2025.89888.4073

Abstract

Not All Foot Drops Are Equal

Foot drop remains a commonly encountered condition in foot and ankle clinics, often referred from neurology or rehabilitation centers with a presumed diagnosis of dorsiflexor weakness. However, through over a decade of managing post-paralytic patients, I have repeatedly encountered cases that defy this narrow definition. Many presents with a gait pattern resembling classic drop foot, yet examination reveals deeper and more complex dysfunction — involving plantar flexors, invertors, and evertors to varying degrees as a spectrum.



To describe this broader functional impairment, I propose the term “flail-drop foot”: a condition in which the dominant complaint is foot drop, but the actual pathology includes a wider, flaccid motor paralysis spectrum. Recognizing this helps distinguish these patients from isolated extensor lag and leads to more tailored surgical solutions.

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References

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The Archives of Bone and Joint Surgery
Volume 13, Issue 8
August 2025
Pages 457-459

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History

  • Receive Date: 25 July 2025
  • Revise Date: 05 August 2025
  • Accept Date: 26 July 2025

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