SPLIT POSTERIOR TIBIAL TENDON TRANSFER THROUGH THE INTEROSSEUS MEMBRANE IN SPASTIC EQUINOVARUS DEFORMITY

The split posterior tibial tendon transfer procedure was first reporte d by Green for correction of equinovarus hindfoot deformity in patient s with cerebral palsy. A modification of the split posterior tibial te ndon transfer combined with an Achilles tendon lengthening is describe d in 17 children (21 procedures) with a minimum follow-up of 3 years. This modified technique is indicated in young children with a continuo usly spastic posterior tibial tendon to correct a dynamic equinovarus. It restores active dorsiflexion when the anterior tibial and extensor muscles are weak. The anterior half of the split tibialis posterior i s transferred through the interosseus membrane to the dorsum of the fo ot. Excellent or good results and two poor results were noted after a mean follow-up of 29 months. In the patients with an excellent or good result, marked improvement of their equinovarus foot deformity in sta nce and swing phase of gait was seen. In two patients, the procedure f ailed because of technical errors.