[Tendon surgery in equinovarus deformity of the foot in children and adolescents with cerebral palsy]

Abstract

Fifty-eight children or adolescents with cerebral palsy who presented an equino varus deformity of the foot were operated on between the age of 4 to 21 by tibialis posterior tenotomy (23 cases), tibialis posterior transposition (18 cases), tibialis posterior (10 cases) or anterior (6 cases) transfer on the cuboid, with triceps lengthening (37 cases). 56 adolescents were reviewed, 45 had achieved their growth. The foot was painless and weight bearing improved. 15 failures were caused by overcorrection in valgus (7 cases, in 5 of which the tendon was transferred on the cuboid) or under correction and recurrence of the deformity (8 cases). A. walking E.M.G. was not made but a clinical examination of voluntary and automatic activity pre and post operatively in 30 cases, which showed that even after tibialis posterior tenotomy a new muscular activity can appear. We recommend this procedure in the varus deformity of the fore foot associated with triceps lengthening in equino varus deformity when the foot is flexible. When the foot is stiff or in cases of under correction and after 10 years, triple arthrodesis is recommended.