Split posterior tibial-tendon transfers in children with cerebral spastic paralysis and equinovarus deformity.
In the treatment of equinovarus deformity of the foot in children with cerebral spastic paralysis, to supplement heel-cord lengthening, we split the posterior tibial tendon and transferred its posterior half laterally into the peroneus brevis tendon. Thirty-seven operations were performed on thirty-one hemiplegic, quadriplegic, and diplegic children who were followed for a mean of eight years postoperatively (range, four to fourteen years), at which time twenty-six of the thirty-one children were skeletally mature. There were thirty excellent, four good, and three poor results. The results did not deteriorate with time. Thirty-two of thirty-four children with good or excellent results had functioning dorsiflexors of the foot and were brace-free postoperatively. The children who had a poor result had recurrent deformity, but none had development of a calcaneal or calcaneovalgus deformity.
D000293:Adolescent; D000843:Ankle Joint; D002547:Cerebral Palsy / Q000150:complications; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D005531:Foot Deformities, Acquired / Q000209:etiology / Q000601:surgery*; D006801:Humans; D008297:Male; D009128:Muscle Spasticity / Q000150:complications; D013709:Tendon Transfer / Q000379:methods*; D013710:Tendons / Q000601:surgery