Posterior transfer of the tendon of the anterior tibial muscle through
the interosseous membrane to the calcaneus to prevent or correct a
calcaneus deformity was performed in twenty patients (thirty-nine feet) who
had a myelomeningocele. The average age of the patients at the time of the
operation was 4.6 years, and they were followed for an average of six
years. Satisfactory clinical and radiographic results were obtained in
thirty-seven (95 per cent) of the thirty-nine feet. Two patients, one who
was unable to walk and one who walked at home only, had a mild equinus
deformity of the left foot. No patient had a clinical calcaneus deformity,
but there was radiographic evidence of talipes calcaneus in one patient
(two feet). The anterior tibial muscle functioned more consistently when
the operation was performed after the patient was four years old and in
patients who had a fifth lumbar or first sacral motor level.