A Prospective Study of Outcome of Percutaneous Needle Tenotomy for Tendo-achilles Release in Congenital Talipes Equino Varus
Keywords:
Congenital Talipes Equino Varus, Ponseti, Tendo-achilles, TenotomyAbstract
Aim-To study the outcome of percutaneous tenotomy of tendo-achilles using a wide bore needle in Congenital Talipes Equino Varus.
Background-Congenital Talipes Equino Varus is a commonly seen complex congenital foot deformity that can be treated conservative if the Ponseti technique is followed correctly. Percutaneous tenotomy of tendo-achilles forms an integral part of this technique.
Material Methods-Forty nine feet were prospectively studied in thirty two patients, treated with the Ponseti technique between July 2011 and June 2013, out of which forty feet (81.6%) required percutaneous needle tenotomy of tendo-achilles.
Results-Out of these forty feet, thirty six (90%) feet were managed successfully, without any complication of excessive bleeding, pseudo-aneurysm formation or neuro-vascular compromise, which was reported with the conventional tenotomy by a knife.
Conclusion-Percutaneous tenotomy of tendo-achilles with a needle is a easy to learn, safe and effective method of tenotomy in Ponseti technique.
References
Irani RN, Sherman MS. The pathological anatomy of clubfoot. J Bone Joint Surg 1963; 45-A: 45-52.
McKay DW. New concept of and approach to clubfoot treatment: Section I: Principles and morbid anatomy. J Paediatr Orthop 1982; 2: 347-56.
Ponseti IV. Congenital clubfoot: fundamentals of treatment. Oxford: Oxford University Press, 1996.
Ponseti IV. Clubfoot management. J Pediatr Orthop 2000; 20: 699-700.
Ponseti IV. Treatment of congenital club foot. J Bone Joint Surg Am 1992; 74: 448-54.
Ponseti IV, Smoley EN. The classic: congenital club foot: the results of treatment, 1963. Clin Orthop Relat Res 2009; 467: 1133-45.
Scher DM, Feldman DS, van Bosse HJ, Sala DA, Lehman WB. Predicting the need for tenotomy in the Ponseti method for correction of clubfeet. J Pediatr Orthop 2004; 24: 349-52.
Dobbs MB, Gordon JE, Walton T, Schoenecker PL. Bleeding complications following percutaneous tendoachilles tenotomy in the treatment of clubfoot deformity. J Pediatr Orthop 2004; 24:353-7.
Burghardt RD, Herzenberg JE, Ranade A. Pseudoaneurysm after Ponseti percutaneous Achilles tenotomy: a case report. J Pediatr Orthop 2008; 28: 366-9.
Changulani M, Garg N, Bruce CE. Neurovascular complications following percutaneous tendoachilles tenotomy for congenital idiopathic clubfoot. Arch Orthop Trauma Surg 2007; (127): 429-430.
Minkowitz B, Finkelstein BI, Bleicher M. Percutaneous tendo-Achilles lengthening with a large-gauge needle: a modification of the Ponseti technique for correction of idiopathic clubfoot. J Foot Ankle Surg 2004; 43(4): 263-5.
Maranho DAC, Nogueira-Barbosa MH, Simao MN, Volpon JB. Use of a large gauge needle for percutaneous sectioning of the Achilles tendon in congenital clubfoot. Acta Ortop Bras. [online]. 2010; 18(5): 271-6.
Hussain N, Khan T, Ahmed A. Complete subcutaneous tenotomy of tendo-achilles in clubfoot patients – a four year follow up. J Surgery. 2004; 2(1): 17-9.
Patwardhan S, Shyam AK, Sancheti P. Percutaneous Needle Tenotomy for Tendo-achilles Release in Clubfoot – Technical Note. J Ortho Case Reports. 2012; 2(1): 35-6.
Sharma MM, Tiwari P, Sharma SM, Tiwari M. “Modified Ponseti Technique for the Management of Congenital Talipes Equino Varus (CTEV) in Neonates: our Experience in a rural teaching institution”. Journal of Evolution of Medical and Dental Sciences 2014; 3(14): 3618-3626.
Dimeglio A, Bensashel H, Souchet P, et al. Classification of clubfoot. J Pediatr Orthop PartB. 1995; 4:129-136.
Ippolito E, Ponseti IV. Congenital club foot in the human fetus. A histological study. J Bone Joint Surg Am 1980; 62: 8-22.
Morcuende JA, Dolan LA, Dietz FR, Ponseti IV. Radical reduction in the rate of extensive corrective surgery for clubfoot using the Ponseti method. Pediatrics 2004; 113: 376-80.
Ponseti IV, Eugene NS. Congenital clubfoot: The Results of Treatment. J Bone Joint Surg 1963; 45A;2: 261-75.
Lehman WB, Ahmed M, Madan, Sanjeev. A Method for the early evaluation of the Ponseti (Iowa) technique for the treatment of idiopathic clubfoot. J Pediatr Orthop 2003; 12B;2: 133-40.
Downloads
Published
How to Cite
Issue
Section
License
This work is licensed under a Creative Commons Attribution 4.0 International License.
Authors contributing to this journal agree to publish their articles under the Creative Commons Attribution 4.0 International License, allowing third parties to share their work (copy, distribute, transmit) and to adapt it, under the condition that the authors are given credit and that in the event of reuse or distribution, the terms of this license are made clear.
