title: Bleeding complications following percutaneous tendoachilles tenotomy in the treatment of clubfoot deformity.
abstract: Ponseti demonstrated correction of most clubfeet in infants using proper manipulative techniques followed by application of well-molded long-leg plaster casts and a percutaneous tendoachilles tenotomy to correct residual equinus contracture. Medical complications occurring as a result of this technique have not to our knowledge been reported. The authors retrospectively reviewed 134 consecutive infants with 219 idiopathic clubfeet treated with the Ponseti method. A percutaneous tendoachilles tenotomy was performed on 200 clubfeet (91%) at a mean age of 16 weeks (range, 6-77 weeks) when less than 10 degress of ankle dorsiflexion was present after casting. A total of 4 patients had serious bleeding complications following the percutaneous tendoachillis tenotomy--3 due to presumed injury to the peroneal artery and 1 due to injury to the lesser saphenous vein. The authors detail the technique of performing a percutaneous tendoachilles tenotomy and offer guidelines that may help others avoid this same complication.
authors.affiliation: Department of Orthopaedic Surgery, Washington University School of Medicine, Saint Louis, Missouri 63110. USA.mattdobbs@earthlink.net
authors.forename: Matthew B
authors.initials: MB
authors.lastname: Dobbs
authors.forename: J Eric
authors.initials: JE
authors.lastname: Gordon
authors.forename: Timothy
authors.initials: T
authors.lastname: Walton
authors.forename: Perry L
authors.initials: PL
authors.lastname: Schoenecker
mesh_terms: D000125:Achilles Tendon / Q000601:surgery*; D001808:Blood Vessels / Q000293:injuries*; D002370:Casts, Surgical; D003025:Clubfoot / Q000628:therapy*; D005260:Female; D006801:Humans; D007223:Infant; D008349:Manipulation, Orthopedic; D011183:Postoperative Complications / Q000209:etiology*; D012189:Retrospective Studies