Ríos-Ruiz JG, González-Torres DM, Valdez-Jiménez LA

Language: Spanish
References: 15
Page: 123-127
PDF size: 218.85 Kb.

ABSTRACT

Objective: The aim of this study was to determine the healing time of Achilles tendon in pediatric patients treated with Achilles tenotomy with the Ponseti method in Shriners Children’s Hospital of Mexico, AC. Material and methods: Experimental, analytical, prospective, longitudinal study of patients with a diagnosis of idiopathic congenital clubfoot treated with the Ponseti method with serial static and dynamic evaluation by ultrasound in real time with a Siemens Diagnostic Ultrasound System Sonoline 650, linear transducer 10.5 MHz of Achilles tendon before tenotomy and at three, six, nine and 12 weeks after the surgical treatment. Results: A sample of 23 patients, 16 male and seven female, 16 with unilateral and seven with bilateral pathology was obtained, for a total of 39 feet, 18 right and 21 left, with a mean age of 8.3 ± 2.3 months. Before tenotomy, the width was 2.7 ± 0.42 mm; in week three, the average was 3 ± 0.39 mm; at six weeks, 2.92 ± 0.36 mm; ultrasound at nine weeks reported an average of 0.38 ± 2.84 mm, and 2.82 ± 0.39 mm at twelve weeks. They were compared using Student’s t presurgical width and at twelve weeks, without finding difference p › 0.03. Conclusions: Although there is integrity at three weeks after Achilles tenotomy, complete repair is achieved at 12 weeks.

REFERENCES

1. Ponseti IV: Publicaciones médicas Oxford. Pie equino varo congénito. Nueva York: La Prensa Universitaria Oxford, Inc.; 1996.

2. Staheli L: Pie zambo : el método de Ponseti benefactor. Global HELP Publication; 2010.

3. Bergerault F, Fournier J, Bonnard C: Idiopathic congenital clubfoot: Initial treatment. Orthop Traumatol Surg Res. 2013; 99(1 Suppl): S150-9.

4. Lohan I: Treatment of congenital clubfoot using the Ponseti method. Global HELP Organization; 2011.

5. Ponseti IV, Smoley EN: The classic: congenital club foot: the results of treatment. 1963. Clin Orthop Relat Res. 2009; 467(5): 1133-45.

6. Chu A, Lehman WB: Treatment of idiopathic clubfoot in the Ponseti era and beyond. Foot Ankle Clin. 2015; 20(4): 555-62.

7. Morcuende JA, Dolan LA, Dietz FR, Ponseti IV: Radical reduction in the rate of extensive corrective surgery for clubfoot using the Ponseti method. Pediatrics. 2004; 113(2): 376-80.

8. Holguín-Maldonado E, Rosselli-Cock P, Ferreira HH, Mendoza A: Valoración ecográfica de la tenotomía del Aquiles en el método de Ponseti. Rev Col de Or Tra. 2007; 21(1): 31-5.

9. Marleix S, Chapuis M, Fraisse B, Tréguier C, Darnault P, Rozel C, et al: Idiopathic club foot treated with the Ponseti method. Clinical and sonographic evaluation of Achilles tendon tenotomy. A review of 221 club feet. Orthop Traumatol Surg Res. 2012; 98(4 Suppl): S73-6.

10. Mangat KS, Kanwar R, Johnson K, Korah G, Prem H: Ultrasonographic phases in gap healing following Ponseti-type Achilles tenotomy. J Bone Joint Surg Am. 2010; 92(6): 1462-7.

11. Agarwal A, Qureshi NA, Kumar P, Garg A, Gupta N: Ultrasonographic evaluation of Achilles tendons in clubfeet before and after percutaneous tenotomy. J Orthop Surg (Hong Kong). 2012; 20(1): 71-4.

12. Niki H, Nakajima H, Hirano T, Okada H, Beppu M: Ultrasonographic observation of the healing process in the gap after a Ponseti-type Achilles tenotomy for idiopathic congenital clubfoot at two-year follow-up. J Orthop Sci. 2013; 18(1): 70-5.

13. Johnson RR, Friedman JM, Becker AM, Spiegel DA: The Ponseti method for clubfoot treatment in low and middle-income countries: a systematic review of barriers and solutions to service delivery. J Pediatr Orthop. 2017; 37(2): e134-9.

14. Khan SM, Khanzada SM: Ponseti treatment for idiopathic clubfoot deformity —Role of secondary care hospitals. JPak Med Assoc. 2016; 66(1): 111-4.

15. Wainwright AM, Auld T, Benson MK, Theologis TN: The classification of congenital talipes equinovarus. J Bone Joint Surg Br. 2002; 84(7): 1020-4.