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Orthopaedics · Peripheral nerve injuries: ankle-foot orthosis in foot drop
Sample itemA patient has a persistent foot drop after a common peroneal nerve injury at the fibular neck, with no signs of recovery yet. What is the most useful measure while waiting?
Original practice item, not a recalled exam question. Nothing here is recorded.
The answer and the reasoning
C. An ankle-foot orthosis to hold the ankle in neutral and prevent equinus
While a nerve is recovering or if recovery fails, an ankle-foot orthosis holds the foot at a right angle, lets the toes clear the floor and prevents a fixed equinus contracture. Persistent loss may later be treated with a tendon transfer such as tibialis posterior.
Option by option
A. A high-heeled shoe
A raised heel promotes equinus and increases the deformity.
B. Amputation of the foot
Amputation is never indicated for an isolated nerve palsy.
C. An ankle-foot orthosis to hold the ankle in neutral and prevent equinus (correct)
Correct. An orthosis supports dorsiflexion and prevents contracture of the Achilles tendon.
D. Complete bed rest
Bed rest would encourage contracture and does not help the nerve.
Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.
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