Schneider M, Balon K
Clin Orthop Relat Res. 1977 Jun(125):113-8.
Twenty-four children with spastic equinovarus deformity due to cerebral palsy were treated by anterior transfer of the posterior tibial tendon and Achilles tendon lengthening. In five patients, the operation was performed on both sides, making a total of 29 feet available for evaluation after an average follow-up of five years. Only 38 per cent of the results were graded "good" or "satisfactory." Sixty-two per cent were rated as "poor" because of valgus, calcaneus or equinus deformity severe enough to require re-operation. The post-operative deformity was generally evident one or more years after surgery, often progressive, and more disabling as well as more difficult to correct than the original condition. Although the percentage of acceptable results was considerably higher for hemiplegic patients than for others in the study, we conclude that in this group and in all other categories of spastic patients anterior transfer of the posterior tibial tendon should not be performed.
对24例因脑瘫导致痉挛性马蹄内翻畸形的患儿进行了胫后肌腱前移和跟腱延长术治疗。其中5例患者双侧均接受了手术，平均随访5年后，共有29只足可供评估。结果仅有38%被评为“良好”或“满意”。62%被评为“差”，原因是外翻、跟骨或马蹄畸形严重到需要再次手术。术后畸形通常在术后一年或更长时间出现，且常常进展，比原始情况更具致残性且更难矫正。尽管在本研究中偏瘫患者可接受结果的百分比比其他患者高得多，但我们得出结论，对于这组患者以及所有其他类型的痉挛性患者，均不应进行胫后肌腱前移术。
