Can extended casting be an alternative to tenotomy in CTEV patients?

Abstract

Aim: To assess the efficacy of extended serial casting for persistent heel equinus in CTEV.Methods: The current study was a prospective pilot observational study that was conducted from August 2023 to July 2024 on CTEV patients who visited the Orthopaedics OPD at Indira Gandhi Hospital Dwarka, Delhi. The study included all children whose CTEV treatment begin in the age group of 0 to 3-month and having persisting heel equinus after forefoot deformity correctionResults: There were 15 children with 22 clubfeet treated in our hospital during the study period. There were more boys (10) compared to girls (5), with a ratio of 2:1, with 7 (46.6%) bilateral deformities, and 8 (53.3%) unilateral deformities. When unilateral, the right feet were more commonly affected (5, 62.5%) than the left feet (3, 37.5%). Max number of clubfoot patient presented at less than 30 days of age. Mean Final external rotation was 59.94 ± 1.78 degrees. The mean Initial Equinus deformity was 11.44 ± 1.80 degrees, mean Final Dorsiflexion was 21.17 ± 1.46 degrees. Mean total number of casts was 8.4 cast in 15 feet (serial casting and extended casting) and 10 cast in 6 patients (serial casting and extended casting). Average in 21 feet was 8.85 cast. The mean duration of the treatment was 62 days. It was seen that tenotomy was done among only 4.5% children.Conclusion: In CTEV patients, extended serial casting can be employed as a substitute for post-casting percutaneous a chilles tendon tenotomy.