The Journal of Bone and Joint Surgery, Vol 73, Issue 5 734-738, Copyright © 1991 by Journal of Bone and Joint Surgery, Inc
Combined split anterior tibial-tendon transfer and intramuscular lengthening of the posterior tibial tendon. Results in patients who have a varus deformity of the foot due to spastic cerebral palsy
MJ Barnes and JA Herring
Texas Scottish Rite Hospital for Crippled Children, Dallas 75219.
Twenty patients who had a varus deformity of the foot secondary to spastic
cerebral palsy had twenty-two operations involving combined split anterior
tibial-tendon transfer and intramuscular lengthening of the posterior
tibial tendon, with and without concomitant lengthening of the Achilles
tendon. Preoperatively, all patients had had a dynamic varus deformity of
the hindfoot and adduction of the forefoot in both the stance phase and the
swing phase of gait. At an average follow-up of 6.2 years (range, 2.3 to
8.8 years), there were fourteen excellent, four good, and four poor
clinical results. Two patients who had a fixed varus deformity of the
hindfoot and one patient who had a very weak anterior tibial muscle had a
poor result. We concluded that the combined procedure is effective for
correction of a flexible varus deformity of the foot in patients who have
spastic cerebral palsy.