Dhingra Mohit, Cazorla Bak Yasmin, Edokpayi Fortune, Chong Han Hong, Shyamsundar Srinivasan
Trauma and Orthopaedic Department, Kettering General Hospital, Kettering, GBR.
Trauma and Orthopaedic Department, University Hospitals of Leicester NHS Trust, Leicester, GBR.
Cureus. 2022 Dec 22;14(12):e32812. doi: 10.7759/cureus.32812. eCollection 2022 Dec.
Percutaneous scalpel tenotomy is frequently performed as part of congenital talipes equinovarus (CTEV) to correct the equinus deformity. The use of a scalpel is associated with complications such as neurovascular bundle damage and pseudoaneurysms. In the literature, a percutaneous large-bore needle has been found to be a safer alternative to a scalpel for performing tenotomies. The goal of this study was to conduct a systematic review and report a single-center case series on the use of percutaneous needle tenotomy in the treatment of CTEV. A Preferred Reporting Items of Systematic Review and Meta-analysis (PRISMA)-compliant literature search was conducted to identify studies describing the use of a percutaneous needle tenotomy in the treatment of idiopathic CTEV. A retrospective case series of patients with idiopathic CTEV treated with percutaneous needle tenotomy over a seven-year period from a single center were also conducted. The patients' demographics, the location of the clubfoot, and the Pirani score were all recorded. An analysis of descriptive statistics was carried out. Continuous data were expressed as mean and SD, whereas categorical variables were expressed as absolute numbers and percentages (%). The systematic review included eight papers with a total of 1026 feet and a mean age of 10.4 weeks (SD 5.9). There were 47 (0.04%) complications across all studies, with a pooled success rate of 95%. Eleven patients (16 feet) were included in the single-center case study. The patients' initial Pirani score was 4.8 (SD 1.5), with a final score of 0. (SD 0). Four complications occurred in the patient's cohort - one minor bleeding and three recurrences as a result of poor compliance with the post-tenotomy foot abduction brace. In conclusion, the percutaneous Achilles tenotomy of a CTEV foot with a large bore needle is a safe and effective alternative.
经皮手术刀跟腱切断术常作为先天性马蹄内翻足（CTEV）矫正马蹄畸形的一部分进行。使用手术刀会带来诸如神经血管束损伤和假性动脉瘤等并发症。在文献中，已发现经皮大口径针是比手术刀更安全的跟腱切断术替代方法。本研究的目的是进行系统评价并报告单中心关于经皮针跟腱切断术治疗CTEV的病例系列。进行了一项符合系统评价与Meta分析的首选报告项目（PRISMA）的文献检索，以识别描述经皮针跟腱切断术治疗特发性CTEV的研究。还开展了一项单中心的回顾性病例系列研究，纳入了在七年期间接受经皮针跟腱切断术治疗的特发性CTEV患者。记录了患者的人口统计学数据、马蹄内翻足的部位以及皮拉尼评分。进行了描述性统计分析。连续数据以均值和标准差表示，分类变量以绝对数和百分比（%）表示。系统评价纳入了8篇论文，共1026只足，平均年龄为10.4周（标准差5.9）。所有研究中共有47例（0.04%）并发症，汇总成功率为95%。单中心病例研究纳入了11例患者（16只足）。患者初始皮拉尼评分为4.8（标准差1.5）。最终评分为0（标准差0）。患者队列中出现了4例并发症——1例轻微出血和3例因跟腱切断术后足部外展支具依从性差导致的复发。总之，使用大口径针进行CTEV足的经皮跟腱切断术是一种安全有效的替代方法。
