The Management of Spastic Equinovarus Deformity Following Stroke and Head Injury

Spastic equinovarus foot deformity is common in patients with upper motor neuron syndrome following stroke and traumatic brain injury. Equinovarus posture of the foot causes significant problems with shoe wear, standing, transfers, and walking. The deformity often cannot be managed with nonsurgical treatments such as chemodenervation, orthoses, and physical therapy. In fact, these modalities may be more costly and less effective than surgical treatment This article describes evaluation and surgical techniques of combined multitendon transfers and lengthenings for correction of spastic equinovarus deformity. These tendon transfers reliably result in improvement in quality of life.