ArticleInternational orthopaedics2015
The split anterior tibialis tendon transfer procedure for spastic equinovarus foot in children with cerebral palsy: results and factors associated with a failed outcome.
Article in International orthopaedics, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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Who cites it
7 citing papers in PubMed, 25 citations in OpenAlex.
- The split transfer of tibialis anterior tendon to peroneus tertius tendon for equinovarus foot in children with cerebral palsy.Acta orthopaedica et traumatologica turcica · 2020Article
- Split Tibialis Anterior Tendon Transfer to The Peroneus Brevis or Tertius for the Treatment of Varus Foot Deformities in Children with Static Encephalopathy: A retrospective case series.Journal of the American Academy of Orthopaedic Surgeons. Global research & reviews · 2020Article
- Modified split tendon transfer of posterior tibialis muscle in the treatment of spastic equinovarus foot deformity: long-term results and comparison with the standard procedure.International orthopaedics · 2020Article
- Approach to bone procedure in fixed equinovarus deformity in cerebral palsy.Journal of orthopaedics · 2018Article
- [Ilizarov technique combined with limited surgery for correction of spastic clubfoot in adolescents with cerebral palsy].Zhongguo xiu fu chong jian wai ke za zhi = Zhongguo xiufu chongjian waike zazhi = Chinese journal of reparative and reconstructive surgery · 2018Article
- Neuromuscular structure of the tibialis anterior muscle for functional electrical stimulation.Surgical and radiologic anatomy : SRA · 2017Article
- MRI of the tibioastragalus anticus of Gruber muscle: a rare accessory muscle and normal anatomical variant.Skeletal radiology · 2016Article
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Authors and funding
4 authors at 3 institutions in 1 country.
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No grant is acknowledged in the PubMed record.
Abstract
purposeThe aims of the study were to evaluate the outcomes and predictive factors of the split anterior tibialis tendon transfer (SPLATT) procedure for the treatment of the spastic equinovarus deformity in children with cerebral palsy (CCP).
methodsForty-five ambulatory CCP with 68 equinovarus feet, positive for the flexor withdrawal reflex test, aged 8.1 ± 2.5 (range four to 15) years were enrolled. All feet underwent a soft tissue release procedure combined with the SPLATT procedure and were followed for at least 12 months after surgery. The functional outcome was rated using the criteria of Kling and co-workers. Pre-treatment gross motor functional classification system (GMFCS) levels were compared to the patients' latest evaluations. Factors associated with outcomes and success rate were assessed.
resultsAt an average follow-up of 5.5 ± 3.3 (range 1.1-16) years, feet were rated as excellent in 48 cases (70 %), good in ten (15 %) and poor in ten (15 %), respectively. Thirty-four CCP showed an improvement for the GMFCS level, P < 0.001. The factor that could predict a poor outcome was the pre-treatment GMFCS levels 3-4 with an odds ratio (95 % CI) of 4.92 (0.96-25.2), P = 0.03. The ten years success rate of the SPLATT procedure between CCP with GMFCS levels 1-2 and levels 3-4 were not different with a mean ± SD (95 % CI) of 0.85 ± 0.1 (0.5-0.96) versus 0.6 ± 0.1 (0.3-0.8), P = 0.08, respectively.
conclusionsThe SPLATT procedure provides a balanced function of the foot, thus improving the ambulatory ability in CCP and should be integrated into the surgical plan. Pre-treatment GMFCS levels 3-4 predicted unfavourable outcomes and should be addressed during pre-operative parental counselling.
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