Abstract
Ultrasonographic aspects of the Achilles tendon after tenotomy for the treatment of congenital clubfoot by the Ponseti technique.
Highlights
The Ponseti technique consists in percutaneous tenotomy of the Achilles tendon for correction of congenital talipes equinovarus
After tenotomy of the Achilles tendon, there is a separation, and the space between the tendons caused by the retraction of the proximal stump is filled in by a hematoma, characterized by echogenic debris, which evolves and becomes fibrous tissue that is seen on ultrasound
Ultrasound is accepted as a reliable method for the routine assessment of tendons, which allows a dynamic assessment and is extremely useful in evaluating regeneration of the Achilles tendon after Ponseti tenotomy
Summary
The Ponseti technique consists in percutaneous tenotomy of the Achilles tendon for correction of congenital talipes equinovarus (clubfoot). The ultrasound examination of individuals with clubfoot involves the use of a high-resolution multifrequency linear transducer to obtain longitudinal and transverse images of the Achilles tendon (Figures 1 and 2, respectively), evaluating the regeneration of the tendon in terms of its thickness and echogenicity, the peritendinous structures, the gap between the stumps, and adherence of the skin to the tendon. After tenotomy of the Achilles tendon, there is a separation, and the space between the tendons caused by the retraction of the proximal stump is filled in by a hematoma, characterized by echogenic debris, which evolves and becomes fibrous tissue that is seen on ultrasound. The phases of the tendon healing process can be divided into the inflammatory phase, in which the hematoma forms and subsequently organizes; the proliferative phase, in which there is growth and maturation of connective tissue fibers in the gap; and the remodeling phase, in which with the tendinous structure organizes into tissue similar to the original[1,4]
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