Indication for Tenotomy in Club feet patients treated by Ponseti Method.

[摘要] Tendo achillis tenotomy is proven method in management of clubfoot using ponseti method but whatare the indication of performing tenotomy and whether it is needed in all patients is the aim of this study. 91patients with 105 clubfeet were assessed at presentation based on pirani score and Ponseti method andprospective study was done and Tenotomy was performed in 89 of the 105 clubfeet (84.76 %). Indication fortenotomy was when seventy degrees of abduction and dorsiflexion was less than 15 degrees and we noted thesecasesatypical club feet (100% of atypical clubfeet) and 202 clubfeet which were having high pirani score atpresentation (98.01% of cases with a Pirani score >=5). Hind foot contracture also correlated with increased needfor tenotomy (76.14% clubfeet with hind foot score >2).Clubfoot treated with Ponseti technique by serial castingis proven method and percutaneous tenotomy is integral step but Tenotomy is not indicated when 75 degreesof abduction and 15 degree of dorsiflexion were achieved but the foot with hind foot score more than 2 atpresentation along with the atypical clubfoot and with pirani score more than 5 can predict the need fortenotomy.

[学科分类] 工程和技术（综合）

[关键词] clubfoot;Ponseti;Tendo Achilles;tenotomy;dorsiflexion.