PATIENTS AND METHODS

The interosseous route remains popular for tibialis posterior tendon transfer for drop-foot. It leaves a smaller range of movement than the circumtibial route, but lengthening the calcaneal tendon may improve this. The results of this present series indicate that, in order to predict a good functional result, the ankle must be held in at least 200 of dorsifiexion at the time of tendon transfer. Transfer ofthe tibialis posterior is indicated for supinated equinovarus deformity of the foot in which the muscle is a deforming force, and therefore especially suitable for transfer to act as an active dorsiflexor. The operation aims to improve gait by providing an active balanced transfer which will obviate the need for a foot-drop splint, or for a posterior bone block (Ingram 1987). Some surgeons consider the transfer to be no more than a tenodesis, but an active range of 15#{176}to 30#{176}of dorsiflexion is reported in most series (Anderson 1964; Srinivasan, Mukherjee and Subramaniam 1968; Warren 1968; Malaviya 1981). The purpose of this paper is to review the literature and to analyse the results in a series of tibialis posterior transfers in patients with leprosy