It is suggested that muscle imbalance is the cause of relapse in the majority of recurrent club-foot deformities. Lateral transplantation of the posterior tibial tendon through the interosseous membrane is a feasible and logical procedure for the correction of a relapsed club-foot deformity in which the major problem is muscle imbalance.
The operation was performed on twenty feet since 1959 with ten excellent, six satisfactory, and four unsatisfactory results. Although the follow-up on these young children is short, it would appear that, when it is indicated, this procedure should be performed by the age of two or three years in order to avoid adaptive bone changes. The chief cause for a clinical result less than excellent appeared to be inadequate surgical performance rather than a basic fault of the procedure. In these twenty feet which have been followed for a maximum of three and one-third years, a valgus deformity developed in two. In both of these, the tendon was transplanted to the cuboid instead of the third cuneiform as recommended.
Copyright 1964 by The Journal of Bone and Joint Surgery, Incorporated