Acta Orthop Belg. 2022 Jun;88(2):231-236. doi: 10.52628/88.2.8547.
We aimed to evaluate the clinical and radiological results of early Achilles tenotomy which was performed before Ponseti method in PEV deformities. 37 feet of 26 patients with Dimeglio type 3 and 4 deformities were included in the study. Unlike the classical Ponseti method, patients underwent a mini-open Achilles tenotomy before the first cast. 6-month follow-up of the foot deformities were assessed using Dimeglio classification clinically and lateral talocalcaneal and tibiocalcaneal angles radiologically. There were 20 male and 6 female patients with the median age of 14 days (4-37 days) and 11 bilateral and 15 unilateral deformities. The average follow-up period was 7 months (6-12 months). The mean Dimeglio scores before the Achilles tenotomy and Dimeglio score at the 6 th month follow-up were 14 (11-16) and 4 (4-6) for the right feet, 13 (10-16) and 4 (4-6) for the left feet respectively. The mean number of casting was 3.8 ± 0.4 for right feet and 3.7 ± 0.4 for left feet. The mean talocalcaneal angle was 24 ± 8.2 degrees for the right feet and 27 ± 8.2 degrees for the left feet. The mean tibiocalcaneal angle was 69 ± 12 for the right feet and 72 ± 14 degrees for the left feet. Early Achilles tenotomy can decrease the total number of cast for deformity correction in Ponseti method and provide good clinical and radiological outcomes at 6 th month follow-up in severe PEV deformities according to Dimeglio classification.
我们旨在评估在 Ponseti 方法之前对 PEV 畸形进行早期跟腱切断术的临床和影像学结果。研究纳入了 26 名患者的 37 只脚,其中 Dimeglio 3 型和 4 型畸形 15 只,Dimeglio 5 型和 6 型畸形 22 只。与经典的 Ponseti 方法不同,患者在第一次石膏固定前接受微创跟腱切断术。通过 Dimeglio 分类,对足部畸形进行临床评估,并对侧跟距角和跟骨距骨角进行影像学评估,随访 6 个月。患者包括 20 名男性和 6 名女性,中位年龄为 14 天(4-37 天),11 例双侧,15 例单侧畸形。平均随访时间为 7 个月(6-12 个月)。右侧跟腱切断术前 Dimeglio 评分和 6 个月随访时 Dimeglio 评分分别为 14(11-16)和 4(4-6),左侧分别为 13(10-16)和 4(4-6)。右侧石膏固定次数为 3.8±0.4 次,左侧为 3.7±0.4 次。右侧跟距角为 24±8.2°,左侧为 27±8.2°。右侧跟骨距骨角为 69±12°,左侧为 72±14°。早期跟腱切断术可以减少 Ponseti 方法矫正畸形的石膏固定次数,根据 Dimeglio 分类,在严重 PEV 畸形中,6 个月随访时可获得良好的临床和影像学结果。