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Split Tibialis Anterior Tendon Transfer
Split tibialis anterior tendon transfer is used to manage spastic. In this procedure, a portion of the tibialis anterior tendon is harvested from its insertion at the medial cuneiform and then transferred to the lateral midfoot at the cuboid while preserving the insertion of the remaining tendon. This procedure has applications in the management of flexible equinovarus deformity resulting from cerebrovascular disease, cerebral palsy, hydrocephalus and Arnold-Chiari malformations, brain tumors, cerebral abscesses, traumatic brain injuries, spinal cord injuries, and multiple sclerosis. The procedure relies on basic principles of tendon transfer, and the goal is to create a plantigrade foot. The most common associated procedures include Achilles tendon lengthening, posterior tibial tendon release or lengthening, and release of the toe flexor tendons. This chapter profiles the use of split tibialis anterior tendon transfer for the treatment of patients with spastic equinovarus deformity of the foot. Indications, contraindications, results, and complications are also discussed.