Role of a tendon transfer as a dynamic checkrein reducing recurrence of equinus following distal tibial dorsiflexion osteotomy.

Tibial dorsiflexion osteotomy for recalcitrant equinus in clubfeet is reported to have a high recurrence rate with growth. We present the results of closing wedge tibial dorsiflexion osteotomy and tendon transfers in 15 feet and 11 patients. The mean age at presentation was 7 (range: 3.98-12.38) years. At a mean follow-up of 4.16 (range: 2.09-6.87) years, 11 of the 15 feet remained corrected. Mean correction of the dorsiflexion was 24.5° and mean correction of anterior distal tibial angle was 10.9° at final review. Muscle rebalancing appears to influence bone remodeling and reduce recurrence of equinus.