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23

SEAJCRR. 2015; 4(1): 1160-1167


Percutaneous Tendo Achilles Tenotomy in the management of Equinus Deformity in conservatively treated CTEV

Riyaz Ahmad Dar, Mohd Shafi Bhat, Mohmad Yaseen Rather, Ansar ul Haq, Shera Ifran Ali.

Abstract
Introduction: Idiopathic clubfoot is the most common musculoskeletal birth defect affecting 1 per 1000 live births. The component deformities of clubfoot include equinus, cavus, heel varus and forefoot adductus. Ponseti method has become the popular method for the non-operative treatment of clubfoot all over the world, and percutaneous tendo Achilles tenotomy is a part of this method which is used to expedite the correction of equinus deformity. Objectives: The purpose of this study was to assess the merits of doing percutaneous tendo Achilles tenotomy by comparing tenotomy group with non tenotomy group. Materials and Method: Seventy-nine consecutive patients with 123 idiopathic clubfeet were treated at Hospital for Bone and Joint Surgery Srinagar. The patients were followed prospectively for 2 years and assessed for the results. All feet were initially graded for the severity of deformity by Dimeglio classification , and treated according to the Ponseti method. At the end of the treatment and during post treatment bracing, the tenotomy group was compared with non tenotomy group. Results: Fifty five (70%) children in the study were males and twenty four (30% ) were females. Forty four patients (55.7%) had bilateral involvement. Sixty four patients (81%) were classified as moderate and severe and 15 feet (19%) as very severe as per Dimeglio classification. Tenotomy of tendo Achilles was done in 84.5 % ( 67patients with104 feet) of the feet.Tenotomy group required an average number of 5.7 casts compared to the non-tenotomy group which required average number of 6.73 casts. Conclusion: In conclusion percutaneous tendo Achilles tenotomy is safe and inexpensive procedure with a very low complication rate.

Key words: CTEV, Ponseti Method , Tendo Achilles tenotomy



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