Turazza F, Sanchez E, Allende V, Masquijo J J
Departamento de Ortopedia y Traumatología Infantil, Sanatorio Allende, Córdoba, Argentina.
Acta Ortop Mex. 2023 Nov-Dec;37(6):324-330.
our aim was to evaluate the clinical outcomes and complications of anterior tibialis tendon transfer (ATTT) in children with dynamic supination after clubfoot treatment.
children with dynamic supination after initial treatment with Ponseti method or surgery who underwent ATTT between 2008 and 2020 were included for evaluation. Demographic data, previous treatment, associated procedures and fixation method were analyzed. Functional results were evaluated with the grading system described by Thompson. Complications and their treatment were analyzed.
a total of 39 patients (57 feet) were analyzed. 70% received previous treatment with Ponseti method, 19.3% underwent surgical posteromedial release, and 10.7% another type of surgical treatment. 88% of cases required associated procedures including Achilles tendon lengthening or tenotomy, plantar fasciotomy, tibial osteotomy, lateral column shortening, posterior release. The predominant type of fixation was the pull-out button method (96.5%). The average follow-up was 31.5 months. According to the Thompson grading system, 52 patients presented good results, two fair and three poor. 98.2% of the feet showed active contraction of the transferred tibialis anterior tendon. There were four complications: plantar irritation, synovial cyst in the dorsum of the foot and deep infection. Two feet required unplanned surgery.
anterior tibialis tendon transfer is an effective technique to correct residual dynamic supination in patients with clubfoot.
我们的目的是评估先天性马蹄内翻足治疗后动态旋后儿童行胫骨前肌腱转移术（ATTT）的临床疗效和并发症。
纳入2008年至2020年间接受Ponseti方法或手术初始治疗后出现动态旋后并接受ATTT的儿童进行评估。分析人口统计学数据、既往治疗、相关手术及固定方法。采用Thompson描述的分级系统评估功能结果。分析并发症及其治疗情况。
共分析39例患者（57足）。70%曾接受Ponseti方法治疗，19.3%接受了手术性后内侧松解，10.7%接受了其他类型的手术治疗。88%的病例需要进行相关手术，包括跟腱延长或切断术、足底筋膜切开术、胫骨截骨术、外侧柱缩短术、后侧松解术。主要的固定方式是拔出纽扣法（96.5%）。平均随访31.5个月。根据Thompson分级系统，52例患者结果良好，2例中等，3例较差。98.2%的足显示转移的胫骨前肌腱有主动收缩。有4例并发症：足底刺激、足背滑膜囊肿和深部感染。2足需要进行计划外手术。
胫骨前肌腱转移术是纠正先天性马蹄内翻足患者残余动态旋后的有效技术。
