To explore the application of balance anterior transfer of tibialis posterior muscle and fibula brevis muscle in the treatment of pediatric cavovarus foot and summarize its operative approaches, technical advantages and long-term outcomes.

Twenty-one children with 25 feet of cavovarus foot were treated.The operative age was (11.10±2.08) years and the average follow-up period (4.37±1.14) years.Through surgical soft tissue release, osteotomy (cuboid, medial cuneiform or midtarsal joint osteotomy, etc.) was employed for correcting foot deformity.Transfer advancement of tibialis posterior muscle and peroneus brevis muscle was performed for balancing the strength of foot; Kirschner wire was utilized for fixing osteotomy and cast applied for 6 weeks post-operation.At Year 1 post-operation, therapeutic effect was consolidated by wearing a walking brace and manual massage.During follow-ups, radiological films of weight-bearing foot were taken and angles measured.Foot and ankle functions were evaluated by the scores of American Orthopedic Foot and Ankle Association (AOFAS) Ankle-Posterior Foot and Foot and Ankle Ability Measure (FAAM).

Through comparing radiological manifestations, appearance and functional status of feet before, after and during follow-ups, all of them resumed walking with weight-bearing.One case of recurrent malformation was re-operated.Another case of skin deficit healed after dressing change.No significant difference existed in Kite angle before, after and at the last follow-up (>3 years post-operation) (F=1.973, P=0.162). The differences of Hibbs angle before, after and at the last follow-up (>3 years post-operation) were statistically significant (F=63.831, P<0.001). By pair comparison, mean values before and after operation and at the last follow-up (>3 years post-operation) were statistically different from each other while mean values post-operation and at the last follow-up (>3 years post-operation) were statistically different from each other.Statistically significant differences existed in Meary angle and calcaneus angle pre-operation, post-operation and at the last follow-up (>3 years post-operation) (P<0.001). There was a declining trend of Meary angle over time.For AOFAS and FAAM scores, the differences were statistically significant (P<0.05).

For children with cavovarus foot, balance anterior transfer of tibialis posterior and peroneus brevis may achieve an excellent balance of internal and lateral dorsoflexion strength.It maintains the postoperative efficacy of foot deformity correction.

Talipes/SU; Orthopedic Procedures/MT; Treatment Outcome; Child