For children with cerebral palsy, foot pronation is a common clinical deformity, and the foot touching the ground during walking is mainly at the anterior lateral edge of the foot, and the weight-bearing area of the 5th metatarsal base is painful, leading to instability of the talofibular joint, which in turn affects the whole body balance of the support phase in the early and middle stages due to ankle dorsiflexion disorder, causing limited forward movement of the tibia, which leads to knee hyperextension at the end of the support phase to compensate for the forward movement of the tibia Inadequate, due to knee hyperextension, foot stirrup release force is reduced. The hip joint compensates for flexion, and the ability to clear the ground contour of the affected limb in the swing phase is reduced. In summary, the presence of clubfoot has a great impact on the walking and standing functions of the child, and the deformity progresses rapidly, so treatment must be carried out urgently. There are two main types of treatment: rehabilitation and surgery. Here, let’s understand one by one. Rehabilitation training: The rehabilitation training for children with clubfoot is divided into two types: active movement and passive movement, i.e. the former is carried out by the child himself, while the latter is carried out by parents or rehabilitation teachers as the leader of the training. 1. Active movement: If the child has the ability to walk, the therapist can let him/her walk on two long triangular boards with concave surfaces, which can correct the inversion of the child’s feet; the therapist controls the child in a squatting position and plays with toys, and the therapist fixes the child’s feet in an abducted and externally rotated position, and the child’s weight will inhibit the inversion of the feet. 2.Passive exercise: the child is placed in a supine position, the therapist will abduct and externally rotate the child’s lower limbs, hold the bottom of the child’s foot forward and outward to pull the muscles around the talocrural joint, and repeatedly move the talocrural joint to expand the range of motion of the talocrural joint, the direction of maximum resistance is the direction of pulling. The direction of maximum resistance is the direction of pulling. Do not use excessive force in the pulling process to prevent strain on the tendon. FSPR should be performed on the lumbar spine to solve the spasticity of the lower limbs and to reduce the high muscle tone of the child to create conditions for the full recovery of motor function. This procedure can be followed by specific orthopedic procedures (posterior tibial tendon lengthening, posterior tibial tendon transposition anterior, anterior tibial tendon splitting external transposition, etc.) depending on the specific conditions of the child’s clubfoot. 1, posterior tibial tendon lengthening surgery: posterior tibial tendon lengthening surgery is most often performed by Z-formation, in which a longitudinal incision is made behind the inner ankle, after revealing the tibia, the forefoot is forcefully dorsiflexed and externally turned, the posterior tibial tendon is stretched, and the posterior tibial tendon is Z-shaped lengthened, which can be clearly seen during the surgery to correct the foot inversion deformity. It can also be used to cut only the tendon part of the tendon at the junction of the tendon muscle belly sliding lengthening surgery. Since most of the inversion feet are combined with horseshoe foot deformity, so with this one incision, the Achilles tendon lengthening can be implemented at the same time. 2, posterior tibial tendon transposition anterior surgery: clinical evidence of the effectiveness of this procedure for the correction of spastic clubfoot deformity. Because it can make the posterior tibial tendon assist dorsiflexion, and remove the power foot inversion muscle force and foot plantarflexion muscle force. The authors used this procedure to treat more than 70 patients with cerebral palsy and obtained excellent results in more than 90% of cases. However, it must be used in conjunction with other orthopedic procedures. In cases of combined bony deformity of the foot, the posterior tibialis muscle must be used in conjunction with the correction of the bony deformity, and the stopping point of the tendon should be the same as the stopping point of the third peroneal muscle. Children patients who have light foot entropion, in order to prevent the formation of foot exostosis deformity after muscle displacement, the posterior tibial tendon can be split in half through the tibiofibular interosseous membrane, and the distal end of the short fibular tendon suture. 3, the tibialis anterior tendon splitting external transposition: adapted to the tibialis anterior muscle activity or tension caused by excessive foot pronation deformity. We have applied this surgical method more often and found that it is appropriate for cases with clinically active anterior tibial tendon gongtai eup and inversion in the gait swing phase. If a clubfoot is present at the same time, Achilles tendon lengthening and posterior tibial tendon lengthening are necessary. We believe that a gentle gastrocnemius recession procedure will allow the ankle to be balanced so that the tibialis anterior becomes solely an ankle dorsiflexor. In addition, if the hallux valgus or long toe flexor tendons of the child are significantly spastic their tendons can be lengthened. Dorsal transfer of the maternal long flexor tendon and the common toe flexor tendon to the foot has been used to treat spastic clubfoot with good results. In conclusion, these procedures can improve the motor function of the limb, restore the standing posture and improve the gait of the child. At the same time, long-term postoperative rehabilitation should still be emphasized to restore the normal posture of the child’s foot as soon as possible.