Abstract
Background: Treatment of ambulatory children with spastic cerebral palsy complaining from dynamic equino varus deformity by split tibialis anterior tendon transfer (STATT), because over activity of tibialis anterior muscle and weak antagonist muscles are the main cause of the deformity. Aim: The purpose of this study is to assess the postoperative results of split tibialis anterior tendon transfer, according to Garceau and Palmer criteria. Patients and Methods: 13 feet in 13 ambulatory children with spastic cerebral palsy complaining from dynamic equino varus deformity, preoperatively 7 of the fair,6 of them were poor, while postoperatively 2 of them became excellent,10 of them good and 1 of the fair. Results: The result of this prospective case series study assessed by using Garceau and Palmer criteria. Conclusion: Split tibialis anterior tendon transfer, is a good method for treating ambulatory children with spastic cerebral palsy complaining of dynamic equinovarus deformity of the forefoot and midfoot which is due to overactivity of tibialis anterior muscle and weak antagonists. Keywords: Dynamic equinovarus foot deformity; Split tibialis anterior tendon transfer; Hoffer’s procedure; and Garceau & Palmer criteria.
Highlights
Cerebral palsy is a static encephalopathy defined as a non-progressive disorder of posture and movement 1,2,3,4
A dynamic varus deformity can be treated by split tendon transfer to the outer side of the foot[2]. This is prospective case series study done on 13 ambulatory children with spastic cerebral palsy, 13 feet with dynamic equino varus fore foot and mid foot deformities, between March 2015 and April 2019
The static deformity will changed to dynamic deformity, equinovarus, to control muscles imbalance and prevent recurrence we did split tibialis anterior tendon transfer (STATT)
Summary
Cerebral palsy is a static encephalopathy defined as a non-progressive disorder of posture and movement 1,2,3,4. Cerebral palsy was first described by William Little’s in 1862 and called. In 1974 Hoffer et al first described split tibialis anterior tendon transfer to correct supination and varus deformity of the mid foot secondary to spasticity of the anterior tibial muscle[9,10]. The result of the current study is assessed according to Garceau and Palmer criteria, which is based on the presence or absence of metatarsus adducts, heel varus and equinus. A normal appearing foot other than being smaller than the opposite foot was considered as an excellent result (4 points).
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