Transfer of tibialis posterior tendon in cerebral palsy

Posterior tendon transfer to the dorsum of the foot through the interosseous membrans is an effective procedure for spastic equinovarus deformity. The complications of excessive calcaneal or excessive valgus deformity can be avoided if the transfer is not inserted too tightly with the foot in dorsiflexion and if it is not transferred to a cuboid insertion. Electromyographic activity was demonstrated in some of the transferred muscles during the swing phase of gait. Tendo achillis lengthening in association with posterior tibial transfer must be done judiciously to avoid deformity of the calcaneus.