We report the result of microsurgical selective tibial neurotomy for spastic feet of children and adults. In this study, 45 spastic feet (15: adult, 30: child) were treated over the last 6 years by microsurgical partial resection of preoperatively selected motor fascicles innervating the selected spastic muscles. Spastic component of foot was corrected (Ashworth's grade from 3.9 to 1.4 in children and from 3.8 to 1.6 in adults) immediately after operation in all patients. But three pediatric spastic feet were recurred and 9 contracted feet (4 cases: adult, 5 cases: child) needed a complementary orthopedic correction for acceptable results. The duration of postoperative follow-up was ranging from 6 to 75 months. Selective tibial neurotomy is an effective procedure in the treatment of localized harmful spastic feet of children and adults. It must be performed before the fixed deformities and rehabilitation provided after surgery to achieve good results.
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