Achilles tenotomy as an office procedure: safety and efficacy as part of the Ponseti serial casting protocol for clubfoot

Journal of Pediatric Orthopedics
Ehud LebelAmos Peyser

Abstract

Ponseti demonstrated the correction of clubfoot in infants using manipulation followed by the application of well-molded long-leg plaster casts. Percutaneous Achilles tenotomy was recommended to correct residual equinus contracture in approximately 80% of cases. In the current study, we evaluated the safety of this practice for the treatment of clubfoot when performed as an "office procedure" without sedation or general anesthesia during the final stage of the serial casting protocol. We retrospectively collected data regarding babies who underwent serial manipulation and casting according to the Ponseti protocol for the treatment of clubfoot. All babies managed in the outpatient clinic between 2006 and 2010 were included. Tenotomy was indicated when the forefoot was completely corrected and if the hind-foot showed rigid equinus. Tenotomy was performed by a single scalpel stab in the outpatient clinic, using topical and local anesthesia (without general anesthesia or sedation). The cast was then applied and kept on for 3 weeks. Babies were discharged home after 1 hour of supervision. Surgical reports regarding Achilles tenotomy were reviewed, and data were collected from postoperative notes. We specifically looked for periopera...Continue Reading

References

Dec 5, 2000·Foot & Ankle International·C ChotigavanichayaN Y Otsuka
Jul 31, 2004·The Journal of Foot and Ankle Surgery : Official Publication of the American College of Foot and Ankle Surgeons·Barbara MinkowitzMelissa Bleicher
Jan 5, 2006·The Journal of Bone and Joint Surgery. American Volume·Lance BarkerRobert Hart
Feb 25, 2006·The Journal of Bone and Joint Surgery. British Volume·S L Barker, C B D Lavy
Aug 1, 2006·The Journal of Bone and Joint Surgery. British Volume·P J Dyer, N Davis
Jan 12, 2007·Archives of Orthopaedic and Trauma Surgery·Manish ChangulaniColin E Bruce
Mar 26, 2008·Journal of Pediatric Orthopedics·Rolf D BurghardtAshish Ranade
Sep 30, 2008·Journal of the American Podiatric Medical Association·Ali DoganAhmet Sebik
Jan 9, 2009·Clinical Orthopaedics and Related Research·Noam BorJohn E Herzenberg
Jan 15, 2009·Clinical Orthopaedics and Related Research·Harold J P van BosseDebra A Sala
Jan 23, 2009·Clinical Orthopaedics and Related Research·Lori A KarolRon ElHawary
Dec 1, 2007·Journal of Children's Orthopaedics·Noam BorAaron L Zuckerberg
Aug 25, 2009·Journal of Pediatric Orthopedics·Christine M AlvarezSerap Kaga
Apr 9, 2010·Journal of Pediatric Orthopedics. Part B·Raghav SainiAjay Gulati
Jun 3, 2010·The Journal of Bone and Joint Surgery. American Volume·Karanjit Singh MangatHari Prem
Dec 15, 2010·Current Opinion in Pediatrics·Harold J P van Bosse

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Citations

Nov 19, 2014·World Journal of Orthopedics·Lior ShabtaiJohn E Herzenberg
Jun 25, 2017·Hand : Official Journal of the American Association for Hand Surgery·Robert E Van DemarkVanessa J S Smith
Mar 18, 2014·JBJS Reviews·Pooya Hosseinzadeh, Todd A Milbrandt
Nov 22, 2019·BMC Musculoskeletal Disorders·Tobias M BallhauseKiril Mladenov
Jan 31, 2016·Journal of Children's Orthopaedics·Rhett MacNeilleGarrett Leonard
Jun 29, 2018·Journal of Children's Orthopaedics·B HedrickM D Abbott
Jan 17, 2020·Plastic and Reconstructive Surgery. Global Open·Samantha G MalihaSheel Sharma
Jun 21, 2018·Journal of Orthopaedic Surgery and Research·Ümit TuhanioğluAhmet Kapukaya
Oct 8, 2014·Journal of Pediatric Orthopedics·Lewis E Zionts
Oct 13, 2020·Indian Journal of Orthopaedics·Karthick RangasamyMandeep S Dhillon

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