The treatment of talipes calcaneus by tendon transfer in seventeen cases of polio - abstract

ABSTRACT

Taplipes calcaneus is a deformity of the foot resulting from paralysis of the triceps surae muscle. It produces a very bulbous heel and an unstable foot. The combination of these two factors lead to a very ackward gait. Seventeen cases of talipes calcaneus from the 1957 and 1962 polio epidemics were available for this study. An attempt has been made to treat these cases by the use of tendon transfers. In all these cases there was little choice in the tendon to be transferred as the muscles of the foot were either partially or completely paralysed. Fifteen cases had peroneus longus transfer. In thirteen of these the tendon was transferred directly into the os calcis. The remaining three had tendon transfers into the tend-achilles. Post-operative evaluation of these cases was based on cosmetic appearance of the foot, strenght of contraction of the transferred tendon and the stability of the foot. Of the seventeen cases, there were ten who had marked improvement in the cosmetic appearance of the foot and excellent (grade 5) contraction of the transferred tendon. In five there was fair cosmetic improvement and in two there was very litte. Two cases had only fair (grade 3) contraction of the transferred tendon and four were poor (grade 2). There was a marked improvement in the gait of all these patients due to the improved stability of the foot. This is best borne out by observing these patients walk (AU)