Circumventing tenotomy in idiopathic clubfoot

Abstract

Background: Congenital talipes equinovarus (CTEV) is one of the most common congenital deformities faced by the orthopaedic fraternity. Although, the deformity is treated conservatively initially with Ponseti’s method, the procedure involves performing percutaneous Achilles tendon tenotomy, a procedure that has its own set of potential complications. We describe a novel manipulation technique to circumvent tenotomy in correcting the residual equinus deformity of idiopathic clubfoot. Materials and methods: A total of 30 (43 clubfeet) patients were included in the study and after the correction of cavus, adduction and varus deformity using Ponseti’s method, the residual equinus deformity was corrected using our technique. Results: All the cases with the residual equinus deformity could be corrected by our technique. Conclusion: Idiopathic CTEV presenting within a year can successfully be treated without performing percutaneous tendoachilles tenotomy irrespective of the initial Pirani score at presentation using the manipulation technique employed by us.