Redevelop Of Achilles Tendon After Percutaneous Tenotomy In Idiopathic Clubfoot Patients As Per Ponseti's Method Of Correction Clinically And Using Two Needle

Research Article
Govind Kumar Gupta, Sudha Rani, Chinmay Sahu and S.B.Singh
Regeneration, Achilles tendon ,percutaneous tenotomy

This study is attempt to establish the regeneration of Achilles tendon after percutaneous tenotomy in idiopathic clubfoot patients as per Ponseti's method of correction clinically and using two needles. This prospective study was conducted on babies less than 1 year of age with idiopathic clubfoot deformity admitted in orthopaedics ward of Rajendra Institute of Medical Sciences, Ranchi, Jharkhand with reference to age and sex for the period from December 2012 to September 2014. Babies with neurological condition, Babies with syndromic condition and recurrent, Resistant and complex Clubfoot cases are excluded from the study. Detailed personal history was recorded including the age, sex, father's & mother's name, address, date of first reporting, age of reporting, detailed history of previous treatment, etc. Distance between the two needles was measured with foot in fully dorsiflexion. In each foot clinical evidence of a successful tenotomy was taken as a definitive increase in dorsiflexion at the ankle and lack of a palpable heel cord. Increase in distance between the needle indicates successful tenotomy. Full leg corrective cast was applied for 3 weeks. At 3 weeks and 6 weeks, cast was removed and clinical assessment was done for healing of Tendo Achilles by palpating for heel cord and by Thomson's test. The same procedure of inserting two percutaneous 18 gauge needle as described before was repeated. The distance between the needles was measured. Increase in distance between the two needles shows lack of full continuity of the severed ends of the tendon. A total 47 feet were treated of 30 study subjects. Majority (26 feet of 16 subjects) of the study subject’s was less than 3 months and majority (23, 76.66 %,) are male. There were total 30 cases out of which 13 were unilateral ( 8 right handed ,5 left handed),rest are bilateral. Incidence of CTEV was found to be more in the 1st born child with 22 cases, 6 cases were 2nd born. Incidence of CTEV was found to decrease as the birth order progress. Average distance increased was 6.18 millimeter.