[The surgical management of spastic foot deformities]

Any surgical treatment of spastic foot deformities must be preceded by an exact preoperative analysis of every aspect of the deformity and its functional consequences. The goals of surgical treatment are correction of the deformity, reestablishment of the stability of the foot and preservation of functionally important ranges of motion and muscle strength. These goals can usually be achieved only by a package of several simultaneous procedures. The foot must never be treated in isolation. Proximal joints have to be considered as well as the opposite side, because a plantigrade position of the foot is only possible when the leg is straight. Any postoperative evaluation must also take into account the proximal joints and the opposite leg in unilateral cases. The mere static evaluation of the postoperative results by reporting clinical and radiographic values should be supplemented by dynamic measurements which allow more insight into the functional results.