This composite clinical photograph depicts a key step in a posterior tibialis tendon (PTT) transfer surgical procedure for foot drop. Image A shows an intraoperative view of the lower leg where a surgical incision is held open by metal retractors. The extensor digitorum longus muscle is elevated medially to expose the crural interosseous membrane (indicated by white arrows), which appears as a white, fibrous, translucent tissue plane. Image B displays a 4-cm excised segment of the interosseous membrane resting on a green sterile surgical drape. The specimen is irregularly rectangular, exhibiting a dense fibrous texture with focal areas of blood staining and small amounts of adherent muscle tissue. This excision is performed to create a surgical window, allowing the PTT to pass from the posterior to the anterior compartment without entrapment or mechanical scarring. This visual material is intended for orthopedic and plastic surgery education, focusing on surgical anatomy and tendon transfer techniques.

This clinical photograph shows an intra-operative view of a tendon transfer procedure in the lower extremity, likely following compartment syndrome or traumatic muscle loss. The image captures the dissection of key anatomical structures labeled for educational purposes. A thick Tibialis Posterior (PT) tendon is prominently displayed, split distally into three separate strands for transfer. Other identified tendons include the Tibialis Anterior (A), Extensor Hallucis Longus (B), and Extensor Digitorum Longus (C). These tendons appear as glistening, off-white, fibrous cords against a backdrop of deep red muscle tissue and a bloody surgical field. The surgical environment is characterized by the presence of metallic retractors, blue sterile drapes, and white gauze. This visual demonstrates the surgical approach to correcting foot drop or flexible deformities by utilizing the tibialis posterior as a motor unit to restore dorsiflexion. It is a critical resource for orthopedic and reconstructive surgery education regarding tendon harvesting and repositioning techniques.

A series of clinical photographs (labeled A-F) documenting the surgical stages of a tibialis posterior tendon transfer for the correction of foot drop. Subfigures A and B show preoperative skin markings on the lower leg and dorsum of the foot, indicating the planned surgical approaches for tendon harvesting and insertion. Subfigure C demonstrates the identification and exposure of the tibialis posterior tendon through a medial incision using surgical retractors and forceps. Subfigure D illustrates the proximal delivery of the harvested tendon, showing its characteristic white, cord-like appearance as it is pulled through a proximal leg incision. Subfigures E and F depict the tunneling of the tendon through the interosseous membrane from the posterior compartment to the anterior compartment of the leg, utilizing surgical clamps and sutures for guidance. This procedure is common in orthopedics and rehabilitation medicine for restoring active dorsiflexion by repurposing the tibialis posterior muscle. The imagery demonstrates essential steps including marking, harvesting, and rerouting of the donor tendon.

Clinical photograph showing a posterior view of the lower legs and feet of a pediatric patient, specifically a 5-year-old boy, two years following a right posterior medial release (PMR) with tibialis anterior tendon transfer (TATT). The image illustrates post-surgical foot alignment and morphology. Key visual findings include a bilateral valgus deformity of the hindfoot, with a more pronounced abduction and eversion on the right side compared to the left. The right medial malleolus appears prominent, indicating weight-bearing distribution favoring the medial aspect. The skin and soft tissues around the ankles appear well-healed without significant scarring, edema, or discoloration, suggesting successful recovery from complex orthopedic intervention for congenital or developmental foot deformity. This visual serves as an educational example of post-operative outcomes in pediatric orthopedic surgery for conditions like clubfoot (talipes equinovarus).