Role of percutaneous abductor hallucis tenotomy in treatment of relapsed adduction in clubfoot | ||
| The Egyptian Orthopaedic Journal | ||
| Volume 54, Issue 3, July 2019, Pages 277-281 PDF (1.85 M) | ||
| DOI: 10.4103/eoj.eoj_56_19 | ||
| Author | ||
| Mohamed H. Fadel | ||
| Abstract | ||
| Background The Ponseti technique of clubfoot has gained popularity for initial correction. However, it can be used for relapses and neglected clubfoot. The effect of abductor hallucis tendon (AHT) release on residual adductus deformity in the surgical treatment of congenital clubfoot had gained good respect. Revision surgery should address a specific problem or deformity that has become unacceptably symptomatic and is producing functional problems and pain. The aim of this study was to analyze the effect of AHT release on relapsed adductus deformity in clubfoot. Materials and methods This multicenter prospective study analyzed the data of 25 patients (30 feet) with relapsed adduction between March 2017 and November 2018. The mean age was 10.3 years (range: 3–36 months). All cases were treated with percutaneous AH tenotomy with or without tendo-Achilles tenotomy. There were 17 male and eight females. Inclusion criteria were children who had been treated with conventional Ponseti technique and had complete correction of their deformity at the initial treatment. Neurogenic feet, atypical clubfoot, and syndromic deformities were excluded from this study. Results All cases were fully corrected after cast removal (4 weeks). A total of two (6.6%) cases (2 feet) had recurrence of adduction after 3 months, detected during the follow-up period (). According to Pirani score, all cases were improved, except for two cases that needed further intervention. It was found that both sex and the side affected had no statistical significance effect on the end result. The age was an important factor affecting the results as the cases relapsed were above 2 years. The relationship between bilaterality or unilaterality in relation to final result was statistically insignificant. Conclusion Treatment of relapsed adduction component of clubfoot by AHT release is successful. The younger the age of the patient at beginning of treatment, the better were the results. Regular follow-up and cooperative parents are very important to prevent recurrence. AHT shortens the duration of casts required to correct forefoot adduction. | ||
| Keywords | ||
| Abductor hallucis; clubfoot; relapse | ||
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