2015
DOI: 10.1007/s00264-015-2793-8
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The split anterior tibialis tendon transfer procedure for spastic equinovarus foot in children with cerebral palsy: results and factors associated with a failed outcome

Abstract: The 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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Cited by 21 publications
(30 citation statements)
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“…Limpaphayom et al performed a SPLATT to the cuboid on 68 equinovarus feet in 45 ambulatory children with CP (average age 8.1 years); they reported excellent or good outcomes in 85% of feet and improved the GMFCS levels in 34 children (75.6%). 11 Ten percent of children had a poor outcome, which was predicted by a pretreatment GMFCS of 3 to 4. By contrast, our current results show no predictive value of the GMFCS level for recurrent varus or the development of pes valgus.…”
Section: Discussionmentioning
confidence: 96%
See 1 more Smart Citation
“…Limpaphayom et al performed a SPLATT to the cuboid on 68 equinovarus feet in 45 ambulatory children with CP (average age 8.1 years); they reported excellent or good outcomes in 85% of feet and improved the GMFCS levels in 34 children (75.6%). 11 Ten percent of children had a poor outcome, which was predicted by a pretreatment GMFCS of 3 to 4. By contrast, our current results show no predictive value of the GMFCS level for recurrent varus or the development of pes valgus.…”
Section: Discussionmentioning
confidence: 96%
“…Split anterior tibialis tendon transfer (SPLATT) is a well-described treatment of varus foot deformities in individuals with neuromuscular disorders. 7 8 9 10 11 12 The split tendon has classically been transferred to the cuboid 9 - 11 , 13 or base of the fifth metatarsal. 14 These transfers to bone, which have often been performed by suturing over a plantar bolster or felt and a button, can result in skin callus, tissue necrosis, plantar hypersensitivity, and transfer failure in patients with spasticity.…”
mentioning
confidence: 99%
“…Comparable preparatory dissections are done to reach the target muscle belly also during muscle lengthening surgery . One aim is to improve agonistic and antagonistic force balance (Limpaphayom et al, 2015). Another is to increase the operational joint ROM of the target muscle .…”
Section: Discussionmentioning
confidence: 99%
“…Fascial connections of the target muscle's belly to surrounding structures are dissected in order to mobilize it for the main objective of transferring the tendon onto an antagonistic muscle insertion (Green, 1957;Limpaphayom et al, 2015). Comparable preparatory dissections are done to reach the target muscle belly also during muscle lengthening surgery .…”
Section: Discussionmentioning
confidence: 99%
“…5,6 Split anterior tibialis or total anterior tibialis tendon transfer also would have corrected flexible equinovarus foot. 7,8 Failure of tendon balancing procedure may came from either failure of identifying fixed deformity component, severity of muscle spasticity, tendon procedure which was done in the older age children, as well as experience of attending surgeon.…”
Section: Introductionmentioning
confidence: 99%