The congenital talipes equinovarus (clubfoot) is one of the most common congenital conditions requiring orthopedic intervention. This study was carried out to evaluate the effect of unintentional partial Achilles tendon cut during percutaneous tenotomy on the success rate of Ponseti management. Percentage of Achilles tendon cut following percutaneous tenotomy was measured by ultrasound in 16 clubfeet (11 patients). After a mean of 21 months of follow-up, the final results (Dimeglio score) were compared between two groups of patients: those with complete tendon cut and those with partial cut. Complications and parameters such as feeling of pop during tenotomy and ankle dorsiflexion during tenotomy were also compared. There was no significant correlation between the percentage of Achilles tendon cut and increase in ankle joint dorsiflexion, age at diagnosis, or pop sensation. There was no statistically significant difference between the two groups in their ankle joint dorsiflexion, feeling of pop, and final follow-up Dimeglio score. No complications were encountered following tenotomy. One patient needed tibialis anterior transfer at his last follow-up visit. Partial cut of Achilles tendon following tenotomy does not necessarily compromise the final results of Ponseti management. Achieving more than 10°-20° ankle dorsiflexion even with a partial tendon cut can ensure good final results.
Introduction: Humeral nonunion is a condition resulting from lack of healing at the fracture site often associated with alteration of the local biological potential. Case Presentation: A 38-year-old male patient, who had a fracture in the left humerus caused by a fall 8 months earlier was presented. He was treated non-operatively with Sarmiento brace.
Conclusions:The present study introduced a new minimally invasive bridge-plate technique for treatment of humeral shaft nonunion that avoids wide dissection, radial nerve isolation and periosteum stripping. It is a safe procedure, which led to bone healing and good results in a patient with atrophic humeral shaft nonunion.
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