TENDON TRANSFER FOR EQUINOVARUS DEFORMED FOOT CAUSED BY CEREBROVASCULAR-DISEASE

Surgical correction was performed on 125 patients who had equinovarus deformity caused by a cerebrovascular accident and who needed an ankle foot orthosis for walking. The operative procedures involved anterior transfer of the long toe flexors (flexor hallux longus and flexor dig itorum longus; long toe flexor group) or lateral transfer of the anter ior tibial tendon (anterior tibial tendon group), combined with length ening of the Achilles tendon. On evaluation more than 2 years after su rgery, 83 of 110 patients of the long toe flexor group and eight of 15 patients of the anterior tibial tendon group were able to walk withou t a brace. Five patients of the anterior tibial tendon group who had s hown strong contraction of the anterior tibial muscle during the swing phase before surgery, needed a brace because of a drop foot after sur gery. Thus, lateral transfer of the anterior tibial tendon was abandon ed in 1984. Recurrence of varus deformity was seen in approximately 15 % of the patients in both groups. Anterior transfer of the long toe fl exors, using them as dorsiflexor tendons or for tenodesis, seemed to p roduce better results.