Tendon Transfer — Split Posterior Tibialis Tendon Transfer to Peroneus Brevis

Children's Colorado / Center for Gait and Movement Analysis (CGMA) · CGMA Physical Therapy Team, Children's Colorado

Weight-Bearing

NWB x 3 weeks in short leg cast; WBAT weeks 3-6 in cast; cast x 6 weeks total

Key Restrictions

Avoid forceful inversion; avoid forceful/resisted muscle contraction; no impact activities; 6 weeks in short leg cast

Timeline & Phases

Phase 1 (days 1-7): NWB, positioning/stretching, isometrics (glutes/quads/hamstrings); Phase 2 (days 8-21): SLR with cast, begin WB with cast at end of week 3; Phase 3 (day 22+): full ankle ROM all planes, WB/balance, neutral foot alignment in gait, ankle strengthening with theraband at 6 weeks, closed-chain proprioception, scar massage ~4-6 weeks

Notes

Pediatric; indication is equinovarus deformity with out-of-phase posterior tibialis activity; lateral 1/2 of posterior tibialis transferred from navicular to peroneus brevis tendon (distal to lateral malleolus); split longitudinally to MTJ; Children's Colorado CGMA

Surgeon / Author

CGMA Physical Therapy Team, Children's Colorado

Published

October 2007