Tendon transfer for equinovarus deformed foot caused by cerebrovascular disease.
Surgical correction was performed on 125 patients who had equinovarus deformity caused by a cerebrovascular accident and who needed an ankle foot orthosis for walking. The operative procedures involved anterior transfer of the long toe flexors (flexor hallux longus and flexor digitorum longus; long toe flexor group) or lateral transfer of the anterior tibial tendon (anterior tibial tendon group), combined with lengthening of the Achilles tendon. On evaluation more than 2 years after surgery, 83 of 110 patients of the long toe flexor group and eight of 15 patients of the anterior tibial tendon group were able to walk without a brace. Five patients of the anterior tibial tendon group who had shown strong contraction of the anterior tibial muscle during the swing phase before surgery, needed a brace because of a drop foot after surgery. Thus, lateral transfer of the anterior tibial tendon was abandoned in 1984. Recurrence of varus deformity was seen in approximately 15% of the patients in both groups. Anterior transfer of the long toe flexors, using them as dorsiflexor tendons or for tenodesis, seemed to produce better results.
Morita
S
S
Division of Rehabilitation Medicine, Tokyo Medical and Dental University, Japan.
Muneta
T
T
Yamamoto
H
H
Shinomiya
K
K
D000328:Adult; D000368:Aged; D002561:Cerebrovascular Disorders / Q000150:complications*; D003025:Clubfoot / Q000209:etiology / Q000503:physiopathology / Q000601:surgery*; D005260:Female; D005531:Foot Deformities, Acquired / Q000209:etiology / Q000503:physiopathology / Q000601:surgery*; D005684:Gait; D006429:Hemiplegia / Q000150:complications; D006801:Humans; D008297:Male; D008875:Middle Aged; D013709:Tendon Transfer; D014034:Toes