Keegan Gore - Ankle Tendon Transfer Procedure (Bridle Procedure) and Peroneal Nerve Injury/Foot Drop

At 5’11” and 144 pounds, Keegan Gore is an active high school senior and athlete, running track and playing basketball for Basehor-Linwood High School, just outside of Kansas City, Mo.

His quarter-mile speed on the track and his quick, lateral movements on the basketball court contradict the fact that Keegan suffered a traumatic injury to his leg in 2012, causing him and his parents to wonder if Keegan would ever walk normally again.

“I remember it like it was yesterday,” says Keegan’s mother, Ruth. “He was on the freshman football team and it was one of the last games of the season. Keegan had already made several tackles, but on one particular punt, he tried to block it and took a helmet hit to the inside of his knee. When he continued to lay on the field in pain, my husband and I knew it wasn’t going to be alright.”

Keegan was transported by ambulance to a nearby hospital where he was diagnosed with a fracture in his shin (tibia) and a traumatic injury to his peroneal nerve, a peripheral nerve that runs down the leg and impacts the ability to flex the foot.

“I wanted to play basketball,” he said emphatically. “I wanted to play sports. My bone healed fine, but I couldn’t raise my foot. It would just dangle there.”

While some peroneal nerve injuries heal on their own, Keegan’s injury had caused paralysis of some of the muscles in his lower leg. Although he went to physical therapy for weeks and wore a brace to prevent foot drop, he wanted to walk normally without a brace. A year after his injury, he underwent specialized surgery to release pressure on the nerve, but his foot continued to dangle. He then was referred to Jeffrey Johnson, MD, a foot and ankle surgeon at Washington University Orthopedics. Dr. Johnson is nationally recognized for using an innovative tendon transfer procedure to correct foot drop.

Called the Bridle Procedure, it involves transferring a tendon called the posterior tibial tendon from the back of the leg to the front of the leg. The complex 4-step procedure weaves the transferred tendon through the middle of the leg and in between the ankle bones to the front of the leg before it is attached to the top of the foot. The tendon then works to stabilize the weak ankle and restore foot dorsiflexion.

A year after his tendon transfer, Keegan celebrated returning to high school sports as a point guard on his high school basketball team. Over the past two years, he has exceeded the expectations of even his surgeon, Dr. Johnson, who has seen family videos of Keegan jumping and running again.

Says Ruth, “I can see a huge difference in his lateral movement and how he moves. To watch him go through all this was so hard, but Dr. Johnson really wanted to make Keegan’s life better. Now he has his whole life ahead of him and he can continue his love of sports. I’m so glad we traveled to St. Louis to see Dr. Johnson.”

Dr. Johnson has had several young men, mostly of college age, do extremely well and return to sports after the Bridle Procedure. All have been able to be brace free for most activities after surgery.

Dr. Johnson retired from Washington University Orthopedics in the fall of 2020. If you have a foot or ankle concern, please contact our board-certified, fellowship-trained foot and ankle specialists at 314-514-3500. 

More Info:

Read about Dr. Johnson’s research, “Outcomes of the Bridle Procedure for the Treatment of Foot Drop” that appeared in the November 19, 2015 edition of the medical journal Foot & Ankle International here.

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