title: Posterior tibial tendon transfer in the spastic brain-damaged adult does not lead to valgus flatfoot.
abstract: BACKGROUND
  We studied the possible development of valgus flat foot after transfer of the posterior tibial tendon to the lateral cuneiform, used for surgical restoration of dorsiflexion in brain-damaged adult patients with spastic equinovarus foot.
  
  
  METHODS
  Twenty hemiplegic patients were reviewed with a mean postoperative follow-up of 57.9 months. Weightbearing radiographs, static baropodometry analysis and functional evaluation were used to assess postoperatively outcomes.
  
  
  RESULTS
  On the operated side, weightbearing radiographs showed an absence of medial arch collapse and a symmetrical and physiological hindfoot valgus; static baropodometric analysis showed a reduced plantar contact surface with a pes cavus appearance. The surgical procedure yielded good functional results. Nineteen patients were satisfied with the outcome of their surgery.
  
  
  CONCLUSIONS
  Our findings support that transfer of the posterior tibial tendon does not lead to valgus flat foot in the spastic brain-damaged adult, and is still a current surgical alternative for management of spastic equinovarus foot.
authors.affiliation: Explorations Fonctionnelles Physiologiques, CHU Rangueil, 1 Avenue Jean Poulhes, 31059 Toulouse Cedex 9, France. gasq.d@chu-toulouse.fr
authors.forename: D
authors.initials: D
authors.lastname: Gasq
authors.forename: F
authors.initials: F
authors.lastname: Molinier
authors.forename: N
authors.initials: N
authors.lastname: Reina
authors.forename: P
authors.initials: P
authors.lastname: Dupui
authors.forename: P
authors.initials: P
authors.lastname: Chiron
authors.forename: P
authors.initials: P
authors.lastname: Marque
mesh_terms: D000328:Adult; D000368:Aged; D003025:Clubfoot / Q000150:complications / Q000503:physiopathology / Q000601:surgery*; D005260:Female; D005413:Flatfoot / Q000209:etiology / Q000517:prevention & control*; D005500:Follow-Up Studies; D006429:Hemiplegia / Q000150:complications*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D013709:Tendon Transfer / Q000379:methods*; D013710:Tendons / Q000601:surgery*; D013977:Tibia; D013997:Time Factors; D016896:Treatment Outcome; D016474:Weight-Bearing; D055815:Young Adult
keywords: Equinovarus; Hemiplegia; Posterior tibial tendon transfer