Twenty patients who had a varus deformity of the foot secondary to
spastic cerebral palsy had twenty-two operations involving combined split
anterior tibial-tendon transfer and intramuscular lengthening of the
posterior tibial tendon, with and without concomitant lengthening of the
Achilles tendon. Preoperatively, all patients had had a dynamic varus
deformity of the hindfoot and adduction of the forefoot in both the stance
phase and the swing phase of gait. At an average follow-up of 6.2 years
(range, 2.3 to 8.8 years), there were fourteen excellent, four good, and
four poor clinical results. Two patients who had a fixed varus deformity of
the hindfoot and one patient who had a very weak anterior tibial muscle had
a poor result. We concluded that the combined procedure is effective for
correction of a flexible varus deformity of the foot in patients who have
spastic cerebral palsy.