208 CLINICAL ORTHOPAEDICS AND RELATED RESEARCH Number 383, pp. 208–213 © 2001 Lippincott Williams & Wilkins, Inc. A system for assessing the results of tibialis pos- terior tendon transfers in the treatment of foot drop secondary to nerve palsy is proposed. There are seven sections to this scoring system: pain, need for orthosis, ability to wear normal shoes, activity level, muscle power of ankle dor- siflexion, degree of active ankle dorsiflexion, and foot posture. The total score is 100. The results are classified as excellent for scores between 85 and 100, good between 70 and 84, fair between 55 and 69, and poor for scores below 55. The re- sults of 18 patients (mean followup, 64.6 months) who had a tibialis posterior tendon transfer were assessed using this method. Four patients (22.2%) had an excellent result, seven (38.8%) had a good result, two (11.1%) had a fair result, and five (27.7%) had a poor result. The average score was 67.2, suggesting an over- all fair result for this operation. In nine patients, there was correlation between the outcome when assessed with this method and with patient rating. In two patients, the outcomes were bet- ter when assessed with this method than with patient rating, whereas the reverse was true in seven other patients. Thus, this system may pro- vide a more objective and critical evaluation of tibialis posterior transfers for foot drop. Although many methods have been described for performing a tibialis posterior tendon transfer for the treatment of a foot drop, the methods used to evaluate the results of the transfer have not been clearly defined. Watkins et al 17 in 1954 reported 17 excellent results, seven good results, and one fair result. The results were excellent if there was satis- factory improvement in the foot posture with good power of the transplanted muscle and if the gait was significantly better. Gunn and Molesworth 4 in 1957 reported a satisfactory result in 49 of 53 patients without defining a satisfactory result clearly. Lipscomb and Sanchez 6 in 1961 defined a good result as one where the patient could dor- siflex the foot to 90° (or within 10° of this) and plantar flex 20° to 30°. There were eight good results, one fair result, and one poor result. All six patients who responded to a questionnaire stated the surgery had produced appreciable improvement. Andersen 1 in 1963 reported 22 excellent re- sults, 50 good results, 30 fair results, and six poor results. The assessment was based on the A Method for Evaluating the Results of Tendon Transfers for Foot Drop Joo Seng Yeap, MB, BCh, BAO*; Dishan Singh, MBBS**; and Rolfe Birch, MBBS** From the *Faculty of Medicine and Health Sciences, University Putra Malaysia, Kuala Lumpur, Malaysia; and the **Royal National Orthopaedic Hospital, Stanmore, England. Reprint requests to Joo Seng Yeap, MB, BCh, BAO, Fac- ulty of Medicine and Health Sciences, University Putra Malaysia, Aras 8, Grand Seasons Avenue, 72, Jalan Pa- hang, 53000 Kuala Lumpur, Malaysia. Received: December 17, 1999. Revised: May 22, 2000. Accepted: June 13, 2000.