Objective: To assess the efficacy of split Tibialis Posterior tendon transfers for the treatment of spastic equino-varus feet.

Materials and Methods: Fourteen patients with 14 spastic equino-varus feet underwent split Tibialis Posterior tendon transfers. The spasticity was due to cerebral palsy, ataxia telangiectasia and traumatic brain injury. All the patients had Ashworth 1–3 spasticity, and the forefoot was correctible in equinus. Evaluation of the results was by grading of the shape of the feet, ambulation, pain and brace tolerance.

Results: One patient was lost to follow-up after an excellent primary result. Twelve patients had good or excellent results, and one patient had a fair result due to partial recurrence of the deformity. No complications were encountered.

Conclusions: Split Tibialis Posterior tendon transfer is a safe and efficacious procedure for the treatment of spastic equino-varus feet. Good alignment of the treated feet allows comfortable brace and shoe wear. Patient selection is important in order to avoid over-correction or recurrence of the deformity.