The results of fifty-seven posterior tibial-tendon transfers through the
interosseous membrane to the dorsum of the foot that were performed in
fifty-one patients who had cerebral palsy, and who were followed for a mean
of 9.3 years (range, five to twenty-six years), were evaluated in terms of
pattern of gait, alignment of the foot, formation of callus on the sole of
the foot, and requirements for bracing. A good or excellent result was
achieved in twenty-seven of thirty feet in the hemiplegic patients, twelve
of sixteen feet in the paraplegic patients, and two of eleven feet in the
quadriplegic patients. We found that in order for the tendon transfer to be
successful the foot had to be passively correctable to at least a neutral
position and that the tendon had to be passed superficial to the extensor
retinaculum and inserted into the lateral cuneiform bone. The heel cord
should be lengthened before the tendon transfer.