Abstract

 Background: Tenotomy for residual equinus is commonly required in the management idiopathic club. The need to reduce complication and cost has made the advancement from mini open to needle tenotomy. This is even more pertinent in low- and middle-income country where clubfoot is more common. The study compared the outcome of needle and blade tenotomy for management of idiopathic club foot.
 Patients and Methods: it is a prospective randomized study of patient requiring tenotomy for residual equinus from July 2015 to June 2020 at a tertiary Orthopediccenter.
 Results:A tenotomy rate of 60 percent was noted. It involves thirty-one patients with forty-three feet were include in the study. The mean follow up was 27,1 months. There was no significant difference in the outcome of equinus correction. Three patients had relapse of deformity, two in the blade group and one in the needle group. All were resolved by further manipulation.
 Conclusion: Needle tenotomy offers similar outcome to blade tenotomy. It is less expensive and more acceptable to those scared of the surgical blade.
Highlights
Idiopathic clubfoot is one of the most common problems in pediatrics orthopaedics.1,2there is nearly universal agreement that the initial treatment of idiopathic clubfoot should be nonoperative.3Ponseti method of clubfoot correction has become the gold standard in clubfoot manangement[4]
TendoAchillestenotomy rate of 79% was originally reported by Ponseti.5Higher tenotomy rate ranging from 86% to 93% were subsequently reported.6,7The management of the equinus deformity has evolved from extensive surgery to mini open procedure and percutaneous tenotomy procedure after serial casting
The need to resolve the residual equinus with less complicationhas led to the drive from mini open surgery to blade tenotomyand needletenotomy.Mickowitz et al 8 first described the needle tenotomy, there have been subsequent reports of the procedure.9-12Some complications have been reported with blade tenotomy in literature
Summary
Idiopathic clubfoot is one of the most common problems in pediatrics orthopaedics.1,2there is nearly universal agreement that the initial treatment of idiopathic clubfoot should be nonoperative.3Ponseti method of clubfoot correction has become the gold standard in clubfoot manangement[4]. TendoAchillestenotomy rate of 79% was originally reported by Ponseti.5Higher tenotomy rate ranging from 86% to 93% were subsequently reported.6,7The management of the equinus deformity has evolved from extensive surgery to mini open procedure and percutaneous tenotomy procedure after serial casting. This may depend on the age at presentation. The need to reduce complication and cost has pushed the advancement from mini open to needle tenotomy This is even more pertinent in low- and middle-income country where clubfoot is more common. The study compared the outcome of needle and blade tenotomy for management of idiopathic club foot
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