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New Research: Needle tenotomy for Ponseti technique
April 13, 2015 /in Latest Research, News /by Rebecca Ward
Percutaneous needle tenotomy for Ponseti technique in the management of Congenital Talipes Equinovarus (CTEV)
Last year surgeons from the Dhaka Medical College and Hospital published this piece of research in the college's medical journal. Together they explore the use of a less invasive technique for Achilles tenotomy as an alternative to the most commonly used percutaneous open tenotomy which requires incision of the ankle to expose the Achilles tendon and potential stitching and scarring as a result. This less invasive technique uses the beveled edge of a needle to transect the tendon and could provide a simpler means to perform Achilles tenotomy with less risk of scarring.
To explore the effectiveness and reliability of this method the technique was performed on 70 feet by the same orthopaedic surgeons in 52 patients being treated for clubfoot. Surgeons used a 19-gauge needle and local anaesthetic to perform the tenotomy after which they applied sterile bandaging and above-knee casting to hold the ankle in dorsiflexion position for 3 weeks.
Results show a mean Pirani score of 4.9 pre-tenotomy which decreased to 0.75 after final casting. This indicates successful tenotomy and successful casting for optimum correction. While there was no soft-tissue or skin infection in any feet there were complications in the tenotomies of 9 feet. 4 feet encountered procedural complications due to aberrant flattening of the tendon, 2 had minor bleeding, and correction could not be achieved in 3 feet due to challenges of 'neglected type' clubfoot.
In conclusion Rahman, M.S., et al. conclude that this simpler percutaneous needle tenotomy offers an alternative to the more invasive open tenotomy technique with few complications and no scarring. To read more about this technique and details of how it compares to open tenotomy download the full article at the link below.
Rahman, M.S., Alam, M.K., Shahiduzzaman, M., and Rahman, A. (2014). Percutaneous needle tenotomy for Ponseti technique in the management of Congenital Talipes Equinovarus (CTEV). Journal of Dhaka Medical College, 23(1), 55-59. DOI: http://dx.doi.org/10.3329/jdmc.v23i1.22695
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