A 47-year-old Caucasian woman spontaneously developed an isolated anterior compartment pressure of >100 mm Hg in the left leg. Despite fasciotomies, the musculature was nonviable and required debridement. Following Achilles tendon lengthening, a posterior tibial tendon (PTT) to anterior tibial tendon (ATT) transfer was supplemented with a flexor digitorum longus tendon transfer to the remaining PTT in order to prevent a flatfoot deformity while restoring active dorsiflexion.Conclusion:
Preservation of the tendinous portion of the ATT during debridement allowed for transfer of the PTT to the ATT using a modified Pulvertaft transfer. This technique allowed early ambulation and restoration of active dorsiflexion, obviating the ongoing use of an ankle-foot orthosis.