What are the causes of foot drop?

Updated: Mar 23, 2020
  • Author: James W Pritchett, MD; Chief Editor: Vinod K Panchbhavi, MD, FACS  more...
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Answer

Foot drop may follow direct injury to the dorsiflexors. A few cases of rupture of the anterior tibial tendon leading to foot drop and suspicion of peroneal nerve palsy have been reported. This subcutaneous tendon rupture usually occurs after a minor trauma with the foot in plantar flexion.

Compartment syndromes also may lead to foot drop. These are surgical emergencies and are not associated only with fracture or acute trauma. March gangrene, a form of anterior compartment syndrome, is thought to be due to edema and small hemorrhages in the muscles of the anterior compartment occurring after strenuous activity in individuals not accustomed to it. Deep posterior compartment syndrome also may result in foot drop as a late sequela due to contracture formation.

Neurologic causes of foot drop include mononeuropathies of the deep peroneal nerve, the common peroneal nerve, or the sciatic nerve. Lumbosacral plexopathy, lumbar radiculopathy, motor neuron disease, or parasagittal cortical or subcortical cerebral lesions also can manifest as foot drop. These lesions can be differentiated by means of clinical and electrodiagnostic examinations.

A common behavioral cause of foot drop is habitual crossing of the legs. [1] These cases typically resolve with discontinuance of the habit.

Foot drop also may be seen as a combination of neurologic, muscular, and anatomic dysfunction. Charcot foot is one example.


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