Split posterior tibial-tendon transfer in spastic cerebral palsy

Area of Science:

• Orthopedic surgery
• Pediatric orthopedics
• Cerebral palsy research

Background:

• Spastic cerebral palsy often causes equinovarus foot deformities.
• Equinovarus deformities significantly impact gait and mobility in affected children.

Purpose of the Study:

• To evaluate the efficacy of split posterior tibial-tendon transfer in correcting equinovarus deformities in children with spastic cerebral palsy.
• To assess the long-term outcomes and potential complications of this surgical intervention.

Main Methods:

• Sixteen children with spastic cerebral palsy and equinovarus deformities underwent split posterior tibial-tendon transfer, often combined with heel-cord lengthening.
• Patients were followed for a minimum of two years postoperatively to monitor outcomes.

Main Results:

• All sixteen patients achieved correction of their varus deformities.
• Two patients required calcaneal osteotomy for fixed varus deformity.
• No recurrences of varus deformities were observed, and no new valgus or calcaneal deformities developed.
• The equinus component of the gait was successfully eliminated in all patients.

Conclusions:

• Split posterior tibial-tendon transfer is a highly effective surgical treatment for equinovarus foot deformities in spastic cerebral palsy.
• The procedure offers durable correction and improves gait without inducing iatrogenic valgus or calcaneal deformities.