Correlation of clinical and ultrasonographic findings after Achilles tenotomy in idiopathic club foot

Barker, Simon; Lavy, Christopher

doi:10.1302/0301-620x.88b3.17273

Cited by 44 publications

(39 citation statements)

References 12 publications

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“…The final long leg cast is applied after the tenotomy and the foot is positioned in 70°of abduction and only 5°to 10°of dorsiflexion. One ultrasound study suggests the tendon heals within 3 weeks of casting [4].…”

Section: Ponseti Methodsmentioning

confidence: 99%

Update on Clubfoot: Etiology and Treatment

Dobbs

Gurnett²

2009

Clinical Orthopaedics &Amp; Related Research

265

275

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Section: Ponseti Methodsmentioning

confidence: 99%

Update on Clubfoot: Etiology and Treatment

Dobbs

Gurnett²

2009

Clinical Orthopaedics &Amp; Related Research

265

275

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“…123,124 The tendon appears to undergo complete repair within six weeks after the sectioning. 120 Repair of the calcaneal tendon after percutaneous tenotomy in the CC was studied more recently verifying fast healing, with recovery of the mechanical transmission of movements in all the cases three weeks after the sectioning. At six months after sectioning, the repair tissue was similar to the normal tendon.…”

Section: Calcaneal Tendon Sectioningmentioning

confidence: 98%

“…73 Clinical studies with late follow-up showed that tenotomy does not cause late onset effects such as tendon weakening and ruptures. 53,60,113,120,121 Previous studies on other types of disease showed that there is complete repair of the calcaneal tendon after its total sectioning at the myotendineous junction 122 , or more distally. 123,124 The tendon appears to undergo complete repair within six weeks after the sectioning.…”

Section: Calcaneal Tendon Sectioningmentioning

confidence: 99%

Pé torto congênito

Maranho

Volpon

2011

Acta ortop. bras.

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The clubfoot is one of the most common congenital deformities affecting the lower limbs, it still presents controversial aspects regarding etiology and treatment. In spite of its relatively high frequency, the treatment is still challenging, since the long-term aim is achieving an everlasting flexible, plantigrade, pain-free and totally functional foot. The Ponseti method has gained attention and popularity because of its satisfactory results and surgery avoidance. Presently, surgical treatment is indicated only after failure of conservative methods, avoiding extensive soft-tissue release, but performing localized corrections of the deformities, a technique also know as "a la carte" release. The future perspective is based on the knowledge about long-term results and new understanding of the clubfoot etiology, especially in the genetic field, which may eventually be helpful for prognostic and treatment. Level of Evidence: Level II, systematic review.

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“…Ponseti demonstrated correction of most clubfeet in infants using proper manipulative techniques followed by the application of well-moulded long-leg plaster casts and a percutaneous tendo-Achilles tenotomy to correct residual equinus contracture [1]. It is possible access a number of reports published in the literature about this old but recently popularised technique [2][3][4]. In the literature, the indication for tenotomy is reported to be necessary in approximately 70-80% of patients [1,4].…”

Section: Introductionmentioning

confidence: 99%

“…Although there is abundant information in the literature describing the Ponseti manipulative and casting technique to correct clubfeet, there are few publications concerning the technique of percutaneous tendo-Achilles tenotomy for residual hindfoot equinus in the clubfoot deformity [1][2][3][4]. Achilles tenotomy should be applied percutaneously and completely, as identified in the original Ponseti technique.…”

Section: Introductionmentioning

confidence: 99%

A comparison of percutaneous and mini-open techniques of Achilles tenotomy: An experimental study in rats

Doğan¹,

Üzümcügil²,

Sarısözen

et al. 2009

Journal of Children's Orthopaedics

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Purpose To investigate the effect of Achilles tenotomy performed percutaneously and by mini-open methods on tendon healing and final strength. Materials and methods In two groups, each consisting of 14 rats, percutaneous and mini-open techniques in Achilles tenotomy were compared in terms of biomechanical, histological and gross properties. Results In the gross evaluation, it was observed that an obvious thickening and adhesion to the subcutaneous tissue of the healing tendon were observed in nearly all rats in which the mini-open technique was performed. In the biomechanical analysis, there was no significant difference between percutaneous and mini-open groups and between operated and intact Achilles tendons in both groups, in terms of tendon strength (P [ 0.05). In the histological evaluation, irregularity in the parallel pattern of the collagen fibres, emergence of a non-specific collagenous tissue formation and infiltration of mild mononuclear inflammatory cells were reported. These changes were more marked in the rats in which the percutaneous technique was performed.Conclusion Mini-open technique for Achilles tenotomy may be considered as an alternative method of treatment to apply the tenotomy technique in a secure way. Clinical relevance There are two basic advantages of Achilles tenotomy performed by the mini-incision open technique: (1) a complete tenotomy is guaranteed, as it has to be in the original Ponseti technique, (2) iatrogenic neuro-vascular injury risk is nearly completely avoided due to the subparatenon exploration of the tendon and direct visual observation during the transection. The mini-open technique may only be used in cases in which a vascular compromise is clinically suspected or confirmed by Doppler ultrasonography and/or arteriography. On the other hand, the technique may be performed in all cases routinely by the choice of the surgeon.

show abstract

Correlation of clinical and ultrasonographic findings after Achilles tenotomy in idiopathic club foot

Cited by 44 publications

References 12 publications

Update on Clubfoot: Etiology and Treatment

Update on Clubfoot: Etiology and Treatment

Pé torto congênito

A comparison of percutaneous and mini-open techniques of Achilles tenotomy: An experimental study in rats

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