BIOMECHANICAL STUDY OF TIBIALIS ANTERIOR TENDON TRANSFER

The tibialis anterior tendon transfer has been used in the treatment o f recurrent congenital clubfoot and paralytic equinovarus foot deformi ties in cerebral palsy This study attempts to determine the optimal si te of tibialis anterior tendon insertion for ankle and foot motion and to compare the split and whole tendon transfer. Ten fresh normal anat omic leg specimens were used, The lateral half of the tibialis anterio r tendon was detached from its insertion, passed beneath the extensor retinaculum, and anchored to the appropriate tarsal bone by a barbed s taple, Tension was applied, and ankle and foot motions were measured. The experiment was done by anchoring the tendon to the tarsal bones al ong the axis of the second metatarsal and serially through to the axis of the fifth metatarsal, The entire experiment was repeated using the whole tibialis anterior tendon, For split tendon transfer, insertion onto the fourth metatarsal axis was the most effective route; it produ ced maximal dorsiflexion with minimal supination and pronation, For wh ole tendon transfer, the ideal site of insertion was along the third m etatarsal axis, However, the difference between the average maximum do rsiflexion achieved by the split tendon transfer and that of total ten don transfer is not statistically significant.