A, Anterior tibial tendon is divided distally and passed subcutaneously to the proximal incision. B, A 4 × 1.5 cm window is created in the interosseous membrane. C, The anterior tibial tendon is transferred posteriorly through the interosseous membrane. D, The transferred tendon is fixed to the calcaneus with a Bunnell suture or suture anchor. (Redrawn from Georgiadis GM, Aronson DD: Posterior transfer of the anterior tibial tendon in children who have a myelomeningocele, J Bone Joint Surg 72A:392, 1990.) SEE TECHNIQUE 34.32.