Anterior tibial tendon transfer in residual dynamic clubfoot deformity

Residual forefoot adduction and supination deformities with functional problems and difficulty with shoe wear may occur during the course of management of the congenital clubfoot. Between 1975 and 1988, 55 patients with 71 feet who had residual dynamic clubfoot deformity underwent anterior tibial tendon transfer. There were 42 full anterior tibial tendon transfers (FTs) and 29 split anterior tibial tendon transfers (STs). The average age of the patient at the time of the procedure was 6 years. The age at surgery for FT was 5.3 years compared with 7.1 years in ST. The clinical appearance of the feet improved in both groups, according to Garceau's criteria. The range-of-motion improvement was noted in dorsiflexion and eversion. There was an increase of eversion strength of both groups by 1.5 grades. The radiographic improvement was noted in both forefoot adduction and supination. Although the FT group had a little better statistical data than did the ST group, the ST group had better preservation of inversion function.