Agarwal Anil, Jandial Gourav, Gupta Neeraj
Department of Paediatric Orthopaedics, Chacha Nehru Bal Chikitsalaya, Geeta Colony, Delhi, 110031, India.
J Clin Orthop Trauma. 2020 Mar-Apr;11(2):240-244. doi: 10.1016/j.jcot.2018.09.001. Epub 2018 Sep 7.
The commonly techniques for anterior tibial tendon transfer (ATTT) for clubfoot are split transfers (Hoffer), whole transfers to cuboid (Garceau) or 3rd cuneiform (Ponseti). We compared these surgical ATTT methods for relapsed clubfoot.
Thirty relapsed clubfoot (46 feet) patients initially treated with Ponseti casting technique were prospectively randomized for ATTT techniques. The outcome was evaluated in terms of foot inversion, eversion and ankle dorsiflexion.
Average follow up was 5.49 months. Whole transfers had better absolute ankle dorsiflexion than split transfers. Foot inversion was comparable in Hoffer and Ponseti transfers but better with Garceau transfers. For eversion, best values occurred with Ponseti transfers. Absolute values of ankle dorsiflexion, foot inversion and eversion obtained with spilt transfers were less than those obtained with whole transfers (statistically insignificant).
No significant differences for foot or ankle function could be detected in this study using the various surgical ATTT techniques in short term follow up.
马蹄内翻足的胫前肌腱转移术（ATTT）常用技术包括劈开转移术（霍弗法）、整体转移至骰骨（加西奥法）或第三楔骨（庞塞蒂法）。我们比较了这些用于复发性马蹄内翻足的手术ATTT方法。
对30例（46足）最初采用庞塞蒂石膏技术治疗的复发性马蹄内翻足患者进行前瞻性随机分组，采用不同的ATTT技术。根据足内翻、外翻和踝关节背屈情况评估结果。
平均随访5.49个月。整体转移术的绝对踝关节背屈情况优于劈开转移术。霍弗法和庞塞蒂法转移术的足内翻情况相当，但加西奥法转移术的足内翻情况更好。对于外翻，庞塞蒂法转移术的效果最佳。劈开转移术获得的踝关节背屈、足内翻和外翻的绝对值低于整体转移术（无统计学意义）。
在本研究的短期随访中，使用各种手术ATTT技术未发现足或踝关节功能有显著差异。
