Gorovitz & Borten, P.C.
Attorneys at Law

550 Cochituate Road, Suite 25
Framingham, Massachusetts
01701
Tel: (781) 890-9095
Foot Drop
Foot drop is defined as a significant weakness of ankle and toe dorsiflexion.
Causes of foot drop vary from neuropathies of different origin such as
diabetic, drug toxicity, stroke to acute injury by direct trauma. The common
denominator is a peripheral nerve injury which affects the muscles that control
the flexion of the foot on the heel; this is sometimes referred as ‘steppage gait’
because the affected individual tends to walk with an exaggerated flexion of
the hip and knee to prevent the toes from catching on the ground. Injury to the
dorsiflexor muscles or to the neural pathway that supplies them will result in a
foot drop.

The sciatic nerve leaves the pelvis through the greater sciatic foramen just
below the piriformis muscle. Subsequently, the sciatic nerve bifurcates to form
the tibial and peroneal nerves. The perineal nerve fibers run more superficially
and are susceptible to injury even prior to its bifurcation when they are still
part of the sciatic nerve. Injury to the peroneal nerve can occur at any point
from the sciatic nerve trunk to the individual fibers down in the lower leg;
severe injuries frequently result in foot drop. Direct trauma that disrupts the
integrity of the nerve fibers or compression injuries that result in ischemia of
blood supply to the nerve itself can both cause foot drop as an end result.

Foot drop that is the result of a chronic medical condition rarely supports a
legal cause of action. Acute injury to the nerve supply at any point along the
neural pathway which result in peroneal nerve palsy is of particular concern
because these can be prevented if proper precautions are taken. Acute injury
that result in peroneal nerve palsy include:

  • Direct compression on the peroneal nerve during surgery (stirrups)
  • Malposition on the operating room table
  • Injury to the peroneal portion of the sciatic nerve
  • Compartment syndromes

Compartment syndromes (anterior, deep posterior) are acute surgical
emergencies that are due to edema or hemorrhage in the muscles of the
anterior and/or posterior compartments which when left untreated or treated in
a delayed fashion may lead to foot drop.

Acute injuries to the peroneal nerve usually become symptomatic shortly after
the conclusion of the surgical procedure when the anesthesia used for the
surgery wears off. Symptoms experienced by the patient depend on the level
where the nerve injury occurred at. Sciatic nerve injuries will produce gluteal
pain that radiates down the leg. Direct injuries to the perineal nerve after it
separates itself from the tibial nerve  will present themselves with pain and lack
of functionality. Attempts at walking even short distances reveal an acute
deficit.

Surgical injuries to the perineal nerve caused by a stitch or a suture ligature
are amenable to reversal with timely surgical intervention. Early nerve
decompression, nerve repair and nerve grafting can aid in restoring
functionality. Electromyography can confirm the type of neuropathy, establish
the site of the lesion and estimate the extent of the injury. Recovery is
unpredictable and related to the underlying cause.

If you believe that you or your loved is suffering from foot drop following a
surgical procedure, have been misdiagnosed, victims of a traumatic peroneal
nerve palsy or wrongly treated and suspect the complications may be the
result of a medical provider’s error that was diagnosable, avoidable and/or
preventable, you may have a valid cause of action. The injury may be the
result of a medical provider's mistake in handling your condition and the result
of medical negligence. Dr. Borten has over 35 years of experience as an
obstetrician and gynecologic surgeon to fully evaluate the merits of your
potential case. Allow the Boston area medical malpractice attorneys at
Gorovitz & Borten help you assert your rights and get the compensation you
deserve.
Contact Information
For a free confidential consultation and receive a response within 24 hours
(when possible), please contact us by phone, fax or e-mail with your question
or concern.

Telephone:  781-890-9095     -     Fax:   781-890-9098
                                                                                     
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