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Acta Ortopédica Brasileira
On-line version ISSN 1809-4406
GABRIELI, Ana Paula T.; STEIN, Helena Elisa and MACHADO NETO, Lauro. Split tibials posterior tendon transfer in the management of spastic talipes varus. Acta ortop. bras. [online]. 2004, vol.12, n.4, pp. 205-211. ISSN 1809-4406. http://dx.doi.org/10.1590/S1413-78522004000400002.
Ten patients with cerebral palsy and varus spastic deformity (12 feet) were evaluated after hemitransposition of posterior tibial tendon. There were 4 female and 6 male patients. Mean age at surgery was 8 years and 9 months. Regarding motor involvement, 6 patients were hemiplegic, 2, diplegic and 2 patients had mixed type cerebral palsy. Mean follow-up was 26 months. Associated surgeries were performed in 92% of the cases (11 feet). Good results were achieved in 67% of the cases and regular results in 25% . There was one bad result (8%). None of the feet developed a calcaneovalgus deformity. Regular and bad results were mainly associated to anterior tibial insufficiency, leading to the maintenance of the orthosis; the influence of other deforming forces on the foot besides the posterior tibial and to the presence of structural bony deformities. The technique of hemitransposition of tibial posterior tendon, associated to other procedures as indicated, leads to good results in correcting spastic varus deformity of the foot in cerebral palsy. Dynamic components of the deformity need to be determined pre-operatively and structural bony deformities must be corrected concomitantly.
Keywords : Cerebral palsy; Varus foot; Muscle Spasticity.