Simultaneous Anterior Tibial Tendon Repositioning and Partial Posteromedial Soft Tissue Surgery for Recurring Clubfoot Deformity in Children between Three and Six Years of Age: A Review

Abstract

Background: Congenital talipes equinovarus (CTEV) is among the most prevalent structural birth defects, affecting approximately 1 per 1000 live births and carrying significant long-term functional consequences when inadequately managed. Despite high initial correction rates with the Ponseti method, relapse occurs in 5–55% of treated cases, most commonly manifesting as dynamic foot supination during the swing phase of gait in children aged 2.5 to 5 years. Combined tibialis anterior tendon transfer (TATT) with limited posteromedial release (PMR) has emerged as the surgical approach of choice for this specific relapse pattern, offering comprehensive correction of both dynamic and static deformity components with low complication rates. This review examines the anatomy, biomechanics, pathological basis, surgical technique, and clinical outcomes of this combined procedure in the 3–6 year age group.