To examine the results of tibialis anterior tendon transfer for the treatment of a calcaneus deformity in children with a myelomeningocele.

Twenty-seven feet in sixteen children were examined in this study. The mean age at the time of surgery was 7(+2) years (range, 4(+11)-14(+9)) and the mean follow up duration was 25 months (range, 15-50). Three-dimensional gait analysis and dynamic foot-pressure measurement were performed to analyze the results of the index operation.

There was no recurrence or aggravation of the deformity. The sagittal kinematics of the ankle improved, and the relative impulse of the calcaneus decreased postoperatively. Those patients with an increased range of motion of the pelvic rotation during gait showed less improvement in the relative impulse of the calcaneus than those with a good range of pelvic rotation. They also had a lower range of knee sagittal motion and an increased range of abduction of the hip, and up-obliquity of the pelvis.

A good range of motion of the hip and pelvis in coronal and transverse planes, and of the knee in the sagittal plane are important predictors of the functional transfer of tibialis anterior tendon in patients with a calcaneal gait in a myelomeningocele.