Review of the Girdlestone-Taylor procedure for clawtoes in myelodysplasia.

To clarify the role the flexor tendon to extensor hood transfer (Girdlestone-Taylor procedure) may have in correction of clawtoes in myelodysplasia, 20 patients with residual paralysis from myelomeningocele who underwent the procedure between 1976 and 1985 were reviewed. They were evaluated for the effectiveness of the procedure and occurrence of late deformities. A total of 25 feet with 65 toes were evaluated in patients ranging in age from 0.6 to 38.8 years. Results were classified as good if toes were straight, fair if mild deformity was present, and poor if definite clawing was noted. The overall results showed 60% good, 34% fair, and 6% poor results. Toes followed less than 24 months had more good results than those with longer follow-up. There was little difference in the results between great toes and lesser toes. No serious complications occurred. Our results indicate a sufficient level of success to utilize this method for correction of flexible claw toe deformities without resorting to bony procedures. We suggest this should be particularly useful in children.