Common causes of foot deformity are polio, cerebral palsy, meningo-myelocoel, CTEV, nerve injury. If this deformity is because of muscle imbalance then it will need tendon transfer along with correction of deformity. Chance of recurrence of deformity became lesser by the use of tendon transfer. We utilize the tendon from remaining muscle in extremity that after transfer do not interfere much in important function of limbs. Selection of tendon is very important during surgery. Power of transferred tendon should be Grade 5 but never less than 4 because after transfer power may decrease upto 1 grade and it should in same direction of pull of weak muscles.
We can utilize complete or half of tendon in transfer. Half tendon transfer are being utilized commonly in cerebral palsy & ctev affected foot. In ctev & cerebral palsy we utilized half tendon of tibialis Anterior to lateral side of foot to balance over action of forefoot inversion and half tendon of tibialis posterior in hind foot inversion of cerebral palsy foot . In foot drop, we transferred tibialis anterior to mid portion of foot and in calcaneous foot we transfer peronie & inverter muscle posterior toward insertion of tendoachilis. After tendon transfer, foot will be protected with plaster for 1 month and then with brace. Vigorous therapy can be started after 6 week and child will to walk after 2 month with brace. Person has to wear brace minimum 3-4 months.
for more information contact
Dr Jitendra kumar Jain
pediatric orthopedic surgeon cum foot surgeon