Sharma Ripudaman, Kumar Arvind, Sinha Siddhartha, Jameel Javed, Khan Rizwan, Kumar Sandeep
Orthopaedics, GS Medical College and Hospital, Pilkhuwa, IND.
Orthopaedics, Maulana Azad Medical College, New Delhi, IND.
Cureus. 2022 Nov 30;14(11):e32080. doi: 10.7759/cureus.32080. eCollection 2022 Nov.
During the COVID-19 surge, due to a lack of operating room availability, we performed Achilles tendon tenotomy in clubfoot patients using a 16/18 gauge needle to avoid delay in their management. The procedures were performed on an outpatient basis. The current retrospective study aims to investigate the effectiveness of needle tenotomy for the correction of equinus in clubfoot at a minimum of one year of follow-up.
Clinical records of all clubfoot patients that underwent needle tenotomy of Achilles tendon from March 2020 onwards with at least one year of follow-up were reviewed. We recorded Pirani scores and the equinus deformity at the initial presentation, after Achilles tendon tenotomy, and at the final follow-up. We also recorded any procedure-related complications following the Achilles tendon tenotomy. We compared dorsiflexion after final cast removal and after one year of follow-up.
A total of 26 clubfeet in 14 patients underwent needle tenotomy of the Achilles tendon and completed one year of follow-up. Ankle dorsiflexion was achievable in all patients and the mean dorsiflexion of 27.4 degrees. The average Pirani score after tenotomy at final cast removal was 0.16, while the mean dorsiflexion at final cast removal was 24.2 degrees (p = .00084). No tenotomy procedure-related complications were noted.
Percutaneous needle tenotomy of the Achilles tendon is a simple, safe, and effective technique for equinus correction in clubfoot. Considering the less invasive nature of the procedure, it can be done as a short procedure on an outpatient basis and has a limited risk of hemorrhage and other wound-related complications.
在新冠疫情高峰期，由于手术室资源紧张，我们使用16/18号针头对马蹄内翻足患者进行跟腱切断术，以避免治疗延误。这些手术均在门诊进行。本回顾性研究旨在通过至少一年的随访，探讨针头切断术矫正马蹄内翻足马蹄畸形的有效性。
回顾了2020年3月起所有接受跟腱针头切断术且随访至少一年的马蹄内翻足患者的临床记录。我们记录了初始就诊时、跟腱切断术后以及最终随访时的皮拉尼评分和马蹄畸形情况。我们还记录了跟腱切断术后任何与手术相关的并发症。我们比较了最终拆除石膏后和随访一年后的背屈情况。
14例患者共26只马蹄内翻足接受了跟腱针头切断术并完成了一年的随访。所有患者均能实现踝关节背屈，平均背屈角度为27.4度。最终拆除石膏时跟腱切断术后的平均皮拉尼评分为0.16，而最终拆除石膏时的平均背屈角度为24.2度（p = 0.00084）。未发现与切断术相关的并发症。
经皮跟腱针头切断术是一种简单、安全且有效的矫正马蹄内翻足马蹄畸形的技术。鉴于该手术的微创性，可以在门诊作为短时间手术进行，且出血和其他与伤口相关的并发症风险有限。
