Split anterior tibial transfer for spastic equinovarus foot deformity: retrospective study of 73 operated feet

The aim of this study was to describe the long-term results of split tibialis transfer in patients with stroke, cerebral palsy, and brain damage due to trauma, tumor, or infection. An evaluation was made of 73 feet in 69 patients with tendon transfer or lengthening for an average follow-up period of 44 months (range, 1 to 14 years). The primary indications for surgery included pain caused by pressure of the foot or toes on the floor or in shoes, ankle instability due to varus deformity, or difficulty wearing orthopedic shoes or braces chi(2) tests were used to compare preoperative and postoperative autonomy, and shoe and orthosis requirements. The results of this study include significant improvement in patient autonomy (p < 0.001), demonstrated by an improved ability to ambulate independently and a decreased need to wear orthopedic shoes (p < 0.001) and orthoses (p < 0.001), as well as an increased ability to wear normal shoes (p < 0.001). This procedure is safe and yields good results with minimal complications. The indications are very common, inasmuch as the number of young hemiplegic or tetraplegic patients surviving after a stroke or head injury is increasing. This procedure can result in definite improvement for these disabled patients and can increase their autonomy.