In the treatment of equinovarus deformity of the foot in children with
cerebral spastic paralysis, to supplement heel-cord lengthening, we split
the posterior tibial tendon and transferred its posterior half laterally
into the peroneus brevis tendon. Thirty-seven operations were performed on
thirty-one hemiplegic, quadriplegic, and diplegic children who were
followed for a mean of eight years postoperatively (range, four to fourteen
years), at which time twenty-six of the thirty-one children were skeletally
mature. There were thirty excellent, four good, and three poor results. The
results did not deteriorate with time. Thirty-two of thirty-four children
with good or excellent results had functioning dorsiflexors of the foot and
were brace-free postoperatively. The children who had a poor result had
recurrent deformity, but none had development of a calcaneal or
calcaneovalgus deformity.