Bleeding complications following percutaneous tendoachilles tenotomy in the treatment of clubfoot deformity.
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.
Dobbs
Matthew B
MB
Department of Orthopaedic Surgery, Washington University School of Medicine, Saint Louis, Missouri 63110. USA.mattdobbs@earthlink.net
Gordon
J Eric
JE
Walton
Timothy
T
Schoenecker
Perry L
PL
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