Posterior transfer of tibialis anterior in low-level myelodysplasia.

A clinical and EMG evaluation was performed on six children with myelomeningocele who previously had undergone bilateral transfer of the tibialis anterior to the heel cord. While the operation was effective in eliminating the calcaneovarus foot deformity, the likelihood of producing a significant new deformity was great. Dynamic EMG studies indicated that the transferred muscle usually did not develop the desired phasic contraction during the stance phase of walking. Bracing requirements at the ankle were unaffected by the procedure. The authors conclude that this transfer is undesirable for children with myelomeningocele.