Revolutionizing Recovery: Tendon Transfer (Bridle Procedure) for Foot Drop in Traumatic Peroneal Nerve Injuries - A Case Series

Introduction: The peroneal nerve, a branch of the sciatic nerve, is vital for lower limb motor and sensory functions. Peroneal nerve injury, commonly caused by high-energy trauma such as traffic accidents, often leads to foot drop—a condition that impairs dorsiflexion and causes gait abnormalities. The Bridle procedure, a surgical technique involving posterior tibial tendon transfer and tri-tendon anastomosis with the anterior tibialis and peroneus longus tendons, is an effective solution to restore dorsiflexion and improve mobility. Case: This paper presents three cases of foot drop caused by peroneal nerve injury following traffic accidents. All patients underwent the Bridle procedure and demonstrated significant postoperative improvements in dorsiflexion and gait. Each case highlights the positive outcomes, with patients achieving functional recovery and improved mobility. Conclusion: The Bridle procedure is a reliable surgical intervention for foot drop caused by peroneal nerve injury, particularly following high-energy trauma. It restores dorsiflexion, enhances gait mechanics, and provides substantial functional recovery, especially in patients with a functional tibialis posterior muscle. Postoperative rehabilitation is crucial for optimizing outcomes. Further research with larger cohorts and longer follow-up periods is necessary to fully understand long-term effects and refine the technique for broader clinical use. Keywords: Peroneal nerve injury, foot drop, Bridle procedure, tendon transfer.