Percutaneous Achilles Tenotomy in Idiopathic Clubfoot treatment

Abstract

Introduction; Percutaneous Achilles tenotomy is a standard procedure in most clubfoot patients treated with Ponseti method as the most widely use method of conservative clubfoot treatment. To our knowledge, there are not studies published in Albanian literature about this technique. Our goal is to present results of conservative treatment of idiopathic clubfoot where this technique was performed. Material and Method. This is a prospective study of all idiopathic clubfoot patients treated in our Institution with Ponseti Method. We performed this technique under sedation anesthesia in operation room, not in clinic. We measured age of patient at time of presentation, gravity according to Pirani score, number of casting, need for Achilles tenotomy). We measured the degree of angle of dorsiflexion before and after this procedure, the gravity and need for a second procedure. Results: Out 400 clubfeet treated during 2005-2010 we included in our study 372 case that needed the percutaneous Achilles tenotomy performed. Average age at presentation was 3 weeks. Average Pirani score was 5.5. The number of weekly serial cast needed before the tenotomy was 8. Dorsiflexion angle after this procedure was improved by 45 degree (range from 30 to 90 degree). Only 2 cases needed reoperation due to non-compliance with foot abduction bar and physiotherapy Conclusion: The percutaneous Achilles tenotomy is used in 93% of case with idiopathic clubfoot serie of patient. It is an easy technique performed with sedation anesthesia in operation room not with local anesthesia. Achilles tenotomy is an important element to avoid recurrence This supports other studies that have used this method.

Keywords

• Clubfoot
• Ponseti
• cast
• posteromedial release