Ultrasonographic Evaluation of Achilles Tendon Healing after Percutaneous Tenotomy for the Correction of Congenital Clubfoot by Ponseti Method
Journal Title: Journal of Bone and Joint Diseases - Year 2017, Vol 0, Issue 0
Abstract
The Study is attempt to establish the regulation of Achilis tendon after percoetaneous tenotomy in idiopathic clubfoot patient as per ponsenti method of correction clinically and evaluation by ultrasound.The prospective study was conduct on 21 patients with idiopathic clubfoot deformity admitted in orthopaedic department of M.L.B. Medical College, Jhansi (UP) with reference to age and sex for the period from Aug 2014 to Aug 2016 babies with neurological condition, syndromic condition, recurrent and complex clubfoot case are excluded from the study. Detailed personal history was recorded including age, sex, father and mother name, address and number of cast applied etc. A mean retraction of 2.26 mm (range 2.3 to11.0 mm) between tendon stump after tenotomy was observe using ultrasound and in each foot clinical evidence of successful tenotomy was taken as a definitive increase in dorsiflexion at the ankle and lack of a palpabale heel cord. Full leg corrective cast was applied for 3 week after 3 week ultrasound showed tendon healing with the tendon gape filled with irregular hypoechoic tissue and along with transmission of muscle motion to the heel. At 6 month after tenotomy there was structural filling a fibrillar aspect, mild or moderate hypo. Echogenicity and tendon scar thickening when compared with a normal tendon. 1 year after tenotomy USG showed a fibrillar structure and echogenicity at the repair site that was similar to a normal tendon but with persistent tendon scaring thickness. There is fast reparative process after Achilles tendon percutanous section after reestablishing conducting between stumps. The reparative tissue evolved to tendon tissue with a normal USG appearance except for mild thickening suggesting a predominating intrinsic repair mechanism.
Authors and Affiliations
Saurabh Agarwal, Ashutosh Kumar
Keywords
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