Spastic foot and ankle deformities: evaluation and treatment.

Spastic foot and ankle deformities can occur from various causes and have profound effects on individuals and society. Presentations can vary clinically and a thorough clinical evaluation, potentially with a dynamic electromyogram, is essential to selecting the most appropriate treatment. Nonoperative treatments, such as orthotics, casting, oral medications, and nerve blocks, can be effective but surgery is indicated if they are no longer effective. Of the various operative procedures to treat this condition, split anterior tibialis tendon transfer and tendo Achilles lengthening are the most commonly performed. Multiple surgical options have been shown to be effective.