Ultrasonographic aspects of the Achilles tendon after tenotomy for the treatment of congenital clubfoot by the Ponseti technique

Watzl, Marcelo de Toledo Piza; Santos, Alair Augusto Sarmet Moreira Damas dos; Neto, Armando Leäo Ferreira; Araujo, Danilo Alves de

doi:10.1590/0100-3984.2018.0086

Cited by 4 publications

(3 citation statements)

References 6 publications

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“…Watzl analyzed the various phases of tendon healing by ultrasound examination in patients treated with tenotomy for congenital clubfoot; the author confirmed the ultrasound changes of the tendon structure that corresponded to those described during the biological healing process [15]. The healing mechanism after Z-plasty lenghtening was probably different, but we assumed that, in this case, the mechanical properties of the tendon were also not comparable to those of the healthy tendon.…”

Section: Discussionmentioning

confidence: 71%

“…The results of Achilles tenotomies have been extensively studied in terms of healing times. Many authors have shown complete restoration of the continuity of the tendon fibers 3-6 weeks after surgery [14][15][16][17] and good functional recovery with no restrictions in sports performance or activity [18,19]. The natural history of tendon healing after tenotomy or Z-plasty lengthening in clubfoot is not well understood [20].…”

Section: Introductionmentioning

confidence: 99%

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Ultrasonic Evaluation of the Achilles Tendon in Patients Treated for Congenital Clubfoot: Comparison between Patients Treated with Plaster Alone, Achilles Tenotomy, and Z-Plasty Lengthening

Pedrotti,

Bertani,

Tuvo

et al. 2024

Children

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Background: Clubfoot is a common congenital deformity. The Ponseti technique, involving early corrective manipulations followed by applying long leg casts and Achilles tenotomy, is widely accepted as the preferred treatment. Rapid tendon healing after surgery has been documented, but the aspect regarding long-term tendon structure and properties is not known. Three cases of Achilles tendon rupture in adolescents previously treated for clubfoot have been described in the literature. As rupture is a rare event in this age group, a possible correlation with previous surgery has been hypothesized. The primary aim of the study was to compare the ultrasound findings of the Achilles tendon in patients treated for clubfoot, between patients treated with casting alone and with patients who underwent surgery (percutaneous tenotomy or Z-plasty lengthening). Methods: There were 22 asymptomatic patients (34 feet) with a median age of 12 years, previously treated for clubfoot, that were recruited for this study; the patients underwent an Achilles tendon ultrasound examination during a follow-up outpatient visit. Results: A greater thickness and increased number of structural alterations with the presence of hypoechoic areas of the operated tendons compared with those treated with plaster alone were observed (p-value: 0.0498 and <0.001, respectively). These ultrasound findings were indicative of tendon suffering, as seen in tendinopathies. Conclusions: The presence of ultrasound alterations in asymptomatic patients operated on for clubfoot requires careful control of the extrinsic factors of tendinopathy in order to reduce the risk of subcutaneous rupture.

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Section: Discussionmentioning

confidence: 71%

Section: Introductionmentioning

confidence: 99%

Ultrasonic Evaluation of the Achilles Tendon in Patients Treated for Congenital Clubfoot: Comparison between Patients Treated with Plaster Alone, Achilles Tenotomy, and Z-Plasty Lengthening

Pedrotti,

Bertani,

Tuvo

et al. 2024

Children

View full text Add to dashboard Cite

show abstract

“…The results of Achilles tenotomies have been extensively studied, as regards healing times. Many Authors showed complete restoration of the continuity of the tendon fibers 3-6 weeks after surgery [14][15][16][17], and good functional recovery, with no restrictions in sport performance or activity [18,19]. The natural history of tendon healing after tenotomy or Z-plasty lengthening in clubfoot is not well understood [20].…”

Section: Introductionmentioning

confidence: 99%

Ultrasonic Evaluation of the Achilles Tendon in Patients Treated for Congenital Clubfoot

Pedrotti,

Bertani,

Tuvo

et al. 2024

Preprint

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Background: clubfoot is a common congenital deformity. The Ponseti technique, involving early corrective manipulations followed by the application of long leg casts and Achilles tenotomy, is widely accepted as the preferred treatment. Rapid healing of the tendon after surgery has been documented, but the aspect regarding tendon structure and properties is not known. Three cases of Achilles tendon rupture in adolescent previously treated for clubfoot have been described in the literature. Since rupture is a rare event in this age group a possible correlation with previous surgery has been hypothesized. The primary aim of the study was to compare the ultrasound findings of the Achilles tendon, in patients treated for clubfoot, between patients treated with casting alone and the ones who underwent surgery (percutaneous tenotomy or Z-plasty lengthening). Methods: 22 asymptomatic patients, (34 feet) median age 12 years, previously treated for clubfoot, were recruited for this study; the patients underwent an Achilles tendon ultrasound examination during a follow-up outpatient visit. Results: a greater thickness and structural alterations with presence of hypoechoic areas of the operated tendons compared to those treated with plaster alone were observed (p value: 0.0498 and

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Achilles tendon surgery in clubfoot: Are long term sequelae predictable?

Pedrotti

Bertani²,

Tuvo³

et al. 2022

Pediatr Med Chir

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Congenital Clubfoot (CCF) treatment involves a surgical procedure on the Achilles tendon most of the time, i.e. tenotomy or, in selected cases, Z-plasty lengthening. Many authors have studied the outcomes of Achilles tenotomy, describing complete clinical and ultrasound tendon fibers integrity restoration 3-6 weeks after surgery. Nevertheless, little is known about the mechanical properties of the operated tendon. Recently, cases of subcutaneous rupture of the Achilles tendon have been described in adolescents who practiced sports and who had undergone Achilles tenotomy for congenital clubfoot in childhood. Authors report two cases of atraumatic Achilles tendon injury (subcutaneous rupture and intratendinous ossification) in adult patients who had been treated for congenital clubfoot in childhood. In both cases, no causes determining the injury were identified; in the medical history there was a Z-plasty lengthening of the Achilles tendon, performed within the first year of life, which could be considered a predisposing factor. The usefulness of long-term monitoring of patients treated for CCF with surgical procedures on the Achilles tendon is therefore hypothesized, in order to promptly identify by symptoms, clinical pictures and ultrasound criteria, tendon suffering that may predispose subcutaneous rupture.

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Ultrasonographic aspects of the Achilles tendon after tenotomy for the treatment of congenital clubfoot by the Ponseti technique

Cited by 4 publications

References 6 publications

Ultrasonic Evaluation of the Achilles Tendon in Patients Treated for Congenital Clubfoot: Comparison between Patients Treated with Plaster Alone, Achilles Tenotomy, and Z-Plasty Lengthening

Ultrasonic Evaluation of the Achilles Tendon in Patients Treated for Congenital Clubfoot: Comparison between Patients Treated with Plaster Alone, Achilles Tenotomy, and Z-Plasty Lengthening

Ultrasonic Evaluation of the Achilles Tendon in Patients Treated for Congenital Clubfoot

Achilles tendon surgery in clubfoot: Are long term sequelae predictable?

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