A patient with isolated common peroneal nerve palsy has foot drop with preserved plantarflexion strength. Which orthosis is most appropriate to correct his gait?

• A Solid ankle-foot orthosis locked in maximum plantarflexion
• B Total contact cast
• C Hip-knee-ankle-foot orthosis with locked knee joints
• D Ground reaction ankle-foot orthosis with anterior shell and dorsiflexion assist ✓

Explanation

Isolated foot drop from peroneal palsy is best managed with an ankle-foot orthosis providing dorsiflexion assistance during swing and controlling plantarflexion at heel strike, eliminating high-steppage gait. A ground reaction or posterior leaf spring AFO is standard here. A solid AFO held in plantarflexion worsens foot drop, a HKAFO is grossly excessive for an isolated L5 lesion, and a total contact cast treats Charcot arthropathy, not foot drop.

Reference: Orthotics and Prosthetics in Rehabilitation, Chui et al., 4th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.