{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,3]],"date-time":"2026-11-03T10:37:55Z","timestamp":1793702275576,"version":"4.5.1"},"reference-count":28,"publisher":"SAGE Publications","issue":"3","license":[{"start":{"date-parts":[[2021,6,1]],"date-time":"2021-06-01T00:00:00Z","timestamp":1622505600000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of Children's Orthopaedics"],"published-print":{"date-parts":[[2021,6]]},"abstract":"<jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>The aim of this study is to report the safety and eff-cacy of soft-tissue surgery incorporating split transfer of tibi-alis anterior to peroneus brevis (SPLATT-PB) for children with hemiplegic spastic equinovarus.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This was a retrospective case series of children and adolescents with spastic hemiplegia who had a novel combination of SPLATT-TB, intramuscular tenotomy of tibialis posterior and either spasticity management or gastrocsole-us lengthening as the index surgery. The principal outcome measures were changes in pain and difficulty with shoe wear and radiological parameters obtained from weight-bearing anteroposterior and lateral radiographs of the affected foot before and after surgery.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 63 patients with symptomatic spastic equinovarus met the inclusion criteria. Mean age at surgery was 9.8 years (6 to 18) and the mean follow-up was seven years (range 3 to 10 years). Foot pain and problems with shoe wear improved after surgery. Seven radiological criteria showed a clinically and statistically significant improvement at follow-up, the majority being in the normal range. There were 11 surgical adverse events, all classified as Modified Cla-vien-Dindo Grade II. Three patients required further surgery for recurrent equinus, eight patients required further surgery for valgus deformities and four patients required bony surgery for residual varus deformities.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Soft-tissue surgery for spastic equinovarus was successful in the majority of children with spastic hemiplegia, particularly between ages eight and 12 years, resulting in a plantigrade, flexible foot with minimal pain or limitations in shoe-wear. Children younger than 8 years at index surgery were more prone to overcorrection into valgus. Children older than 12 years had persistent varus deformities requiring bony surgery.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of evidence<\/jats:title>\n                    <jats:p>Level IV, retrospective case series<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1302\/1863-2548.15.210033","type":"journal-article","created":{"date-parts":[[2021,5,10]],"date-time":"2021-05-10T12:23:47Z","timestamp":1620649427000},"page":"279-290","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":12,"title":["Split anterior tibialis tendon transfer to peroneus brevis for spastic equinovarus in children with hemiplegia"],"prefix":"10.1177","volume":"15","author":[{"given":"Peter","family":"Wong","sequence":"first","affiliation":[{"name":"Orthopaedic Department, The Royal Children's Hospital, Melbourne, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shaneil","family":"Fransch","sequence":"additional","affiliation":[{"name":"Orthopaedic Department, The Royal Children's Hospital, Melbourne, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charles","family":"Gallagher","sequence":"additional","affiliation":[{"name":"Orthopaedic Department, The Royal Children's Hospital, Melbourne, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kate Louise","family":"Francis","sequence":"additional","affiliation":[{"name":"Murdoch Children's Research Institute (MCRI), Melbourne, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abhay","family":"Khot","sequence":"additional","affiliation":[{"name":"Orthopaedic Department, The Royal Children's Hospital, Melbourne, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erich","family":"Rutz","sequence":"additional","affiliation":[{"name":"Orthopaedic Department, The Royal Children's Hospital, Melbourne, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"H. Kerr","family":"Graham","sequence":"additional","affiliation":[{"name":"Orthopaedic Department, The Royal Children's Hospital, Melbourne, Australia"},{"name":"Department of Paediatrics, University of Melbourne."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2021,6,1]]},"reference":[{"key":"bibr1-1863-2548.15.210033","doi-asserted-by":"publisher","DOI":"10.1007\/s11832-013-0509-4"},{"key":"bibr2-1863-2548.15.210033","doi-asserted-by":"publisher","DOI":"10.1097\/01241398-200211000-00020"},{"key":"bibr3-1863-2548.15.210033","doi-asserted-by":"publisher","DOI":"10.1302\/1863-2548.14.200145"},{"key":"bibr4-1863-2548.15.210033","doi-asserted-by":"publisher","DOI":"10.5435\/JAAOSGlobal-D-20-00044"},{"key":"bibr5-1863-2548.15.210033","first-page":"1764","volume":"88","author":"Michlitsch MG","year":"2006","journal-title":"J Bone Joint Surg [Am]"},{"key":"bibr6-1863-2548.15.210033","doi-asserted-by":"publisher","DOI":"10.1016\/S0030-5898(20)31237-2"},{"key":"bibr7-1863-2548.15.210033","doi-asserted-by":"publisher","DOI":"10.1016\/j.gaitpost.2010.05.006"},{"key":"bibr8-1863-2548.15.210033","doi-asserted-by":"publisher","DOI":"10.2106\/00004623-198365060-00004"},{"key":"bibr9-1863-2548.15.210033","doi-asserted-by":"publisher","DOI":"10.1007\/s11999-008-0395-0"},{"key":"bibr10-1863-2548.15.210033","doi-asserted-by":"publisher","DOI":"10.1016\/j.otsr.2012.07.007"},{"key":"bibr11-1863-2548.15.210033","doi-asserted-by":"publisher","DOI":"10.3928\/0147-7447-20040401-10"},{"key":"bibr12-1863-2548.15.210033","doi-asserted-by":"publisher","DOI":"10.3113\/FAI.2009.1207"},{"key":"bibr13-1863-2548.15.210033","doi-asserted-by":"publisher","DOI":"10.1097\/BTF.0b013e3181c264d5"},{"key":"bibr14-1863-2548.15.210033","doi-asserted-by":"publisher","DOI":"10.1097\/00003086-197109000-00010"},{"key":"bibr15-1863-2548.15.210033","doi-asserted-by":"publisher","DOI":"10.1097\/01.bpo.0000173244.74065.e4"},{"key":"bibr16-1863-2548.15.210033","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.I.01150"},{"key":"bibr17-1863-2548.15.210033","doi-asserted-by":"publisher","DOI":"10.1097\/BPO.0000000000001233"},{"key":"bibr18-1863-2548.15.210033","doi-asserted-by":"publisher","DOI":"10.1016\/j.gaitpost.2010.11.025"},{"key":"bibr19-1863-2548.15.210033","doi-asserted-by":"publisher","DOI":"10.1111\/j.1468-1331.1999.tb00031.x"},{"key":"bibr20-1863-2548.15.210033","doi-asserted-by":"publisher","DOI":"10.1302\/0301-620X.97B4.34887"},{"key":"bibr21-1863-2548.15.210033","doi-asserted-by":"publisher","DOI":"10.1007\/s11832-011-0335-5"},{"key":"bibr22-1863-2548.15.210033","doi-asserted-by":"crossref","first-page":"437","DOI":"10.2106\/00004623-198769030-00016","volume":"69","author":"Winters TF","year":"1987","journal-title":"J Bone Joint Surg [Am]"},{"key":"bibr23-1863-2548.15.210033","doi-asserted-by":"publisher","DOI":"10.1046\/j.1468-1331.2001.00042.x"},{"key":"bibr24-1863-2548.15.210033","doi-asserted-by":"publisher","DOI":"10.1302\/0301-620X.87B4.15525"},{"key":"bibr25-1863-2548.15.210033","doi-asserted-by":"publisher","DOI":"10.1016\/j.fcl.2009.06.001"},{"key":"bibr26-1863-2548.15.210033","doi-asserted-by":"publisher","DOI":"10.1302\/0301-620X.57B3.270"},{"key":"bibr27-1863-2548.15.210033","doi-asserted-by":"publisher","DOI":"10.2106\/00004623-198567020-00002"},{"key":"bibr28-1863-2548.15.210033","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2214.2007.00770.x"}],"container-title":["Journal of Children's Orthopaedics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1302\/1863-2548.15.210033","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1302\/1863-2548.15.210033","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1302\/1863-2548.15.210033","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T15:06:35Z","timestamp":1777388795000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1302\/1863-2548.15.210033"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,6]]},"references-count":28,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2021,6]]}},"alternative-id":["10.1302\/1863-2548.15.210033"],"URL":"https:\/\/doi.org\/10.1302\/1863-2548.15.210033","relation":{},"ISSN":["1863-2521","1863-2548"],"issn-type":[{"value":"1863-2521","type":"print"},{"value":"1863-2548","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,6]]}}}