ABSTRACT
Background: Tenotomy of tendon Achilles is one of the major components of Ponseti method and necessary to complete correction in about 80 to 90 % of patients, it is safely procedure can be done in outpatient office as percutaneous technique under local anesthesia or in operative room under general anesthesia as mini-open technique. This study was designed to evaluate effect of tendoachillis tenotomy either percutaneous or open on continuity of tendoachillis by open evaluation in relapsed club foot. Patient & method: This study was conducted on 18 individuals. They were divided into 2 equal groups: Group I: containing 9 patients both sex had previously percutaneous tenotomy is done and Group II: 9 patients both sex had previously open tenotomy is done. Results: percutaneous technique found easy dissection in 6 patients (66.7%) and difficult dissection in 3 patients (33.3%) and continuity found central and regular contour in 7 patients (77.8%) and fibrotic mass in 2 patients (22.2%), open technique found easy dissection in 5 patients (55.6%) and difficult dissection in 4 patients (44.4%) and continuity found central and regular contour in 5 patients (55.6%) and fibrotic mass in 4 patients (44.4%), Conclusion: the techniques tenotomy of tendoachillis had no effect on continuity of tendoachillis either open or closed techniques in management of club foot
Subject(s)
Achilles Tendon/surgery , Clubfoot/surgery , Egypt , Minimally Invasive Surgical Procedures/methods , Tenotomy/methodsABSTRACT
Background: Congenital talipes equinovarus is the most common congenital anomaly of the foot and ankle. The prevalence of this condition in our environment is not known due to dearth of medical literature on the subject. The aim of this study was to determine the outcome of our operative management of resistant talipes equinovarus by elongation of tendo-Achilles and posteromedial soft tissue release. Methods: We present a retrospective review of congenital talipes equinovarus treated by Elongation of tendo Achilles (ETA) and Posterior Medial Release(PMR) at National Orthopaedic Hospital Enugu over a 6- year period (January1995- December 2000). Results: There were 63(68) males and 30(32) females with mean age of 2.06 years at presentation (range 1/12-18years). There was positive family history in 6(7) patients. More than half of the patients 63(68) came without any formal referral. The mode of delivery was spontaneous vaginal delivery in 81(87) and the first child appears to be more affected 22(24). The deformities on presentation varied from talipes equinovarus 50(54) to frank equinus in 3(3) and fifty-four (58) were bilateral. Sixty- three (68) had initial treatment ranging from serial casting in 46(50) to massage by traditional bonesetter in 2(2) and the average duration of this initial treatment was 20weeks (range 2-106weeks). The average age at surgery was 2.5years (range 3/12-24 years). All patients received postoperative cast for an average of 13 weeks. The commonest post- operative complication was medial wound breakdown. The average duration of follow-up was 30 weeks (range3weeks-3years). Some patients were lost to follow-up immediately the cast was removed. As at last visit 90were walking pain-free and do not require special shoe. The commonest residual deformity as at last visit was forefoot adduction in 17(18) patients. Conclusion: Elongation of tendo-Achilles and posteromedial soft tissue release are common operative procedures for CTEV. The short-term result of these procedures appears very good in our environment. However; the long-term result cannot be effectively analyzed due to high rate of loss to follow-up
Subject(s)
Achilles Tendon , Clubfoot , Foot Deformities , Surgical Procedures, OperativeABSTRACT
The purpose of this paper it to emphasise the importance of early detection and treatment of Congenital Talipes Equinovarus deformity (CTEVD). This deformity commonly known as Clubfoot often presents late for medical treatment in our sub-region. This is mainly due to socio-economic factors and probably cultural beliefs. The majority of patients operated on at the Department of Orthopaedics; at Mulago Hospital are normally the variety of neglected Clubfeet. Early detection and treatment of Clubfeet has better prognosis than delayed or neglected Clubfeet. The earlier correction is established; the lower the likelihood of relapses
Subject(s)
Clubfoot , Foot Deformities , OrthopedicsABSTRACT
Il s'agissait d'une etude retrospective portant sur 19 pieds bots varus equins inveteres de l'adolescent et de l'adulte ; traites par liberation postero-interne associee a la double arthrodese de janvier 1990 a decembre 2002 dans le service d'orthopedie traumatologie de l'hopital de Kati. L'objectif etait d'evaluer le resultat du traitement par l'associationsimultanee de ces deux techniques . L'etude a porte sur 19 patients; dont l'age etait compris entre 13 et 38 ans au moment de l'operation et ont ete operes en moyenne 11;6 ans apres la paralysie initiale. Les etiologies responsables de ces deformations ont ete : l'injection intra fessiere 15 cas ; la poliomyelite 2 cas et le traumatisme de jambe 2 cas. 16 pieds etaient vierges de toute chirurgie et 3 avaient ete deja operes dont 1 multi opere. Notre technique operatoire a ete l'association dans le meme temps operatoire de la liberation postero-interne et de la double arthrodese. La correction a ete maintenue avec ou sans agrafe de BLOUNT et une botte platree confectionnee pour deux mois. L'appui ete autorise a trois mois. Un patient apres ce premier temps operatoire a beneficie d'un transfert du JP sur le 3eme cuneiforme a travers la membrane interosseuse. Avec un recul moyen de 4;82 ans les resultats du traitement ont ete satisfaisants dans 18 cas et non satisfaisant dans 1 cas. Une correction plantigrade a ete obtenue chez tous les patients. Au plus grand recul les resultats sont restes satisfaisants