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Achilles tendon tenotomy is the established worldwide gold standard for correcting idiopathic clubfoot. However, in neglected cases, surgical interventions such as percutaneous Achilles tendon tenotomy (PAT) and open tendo-Achilles lengthening (TAL) are common techniques for correcting this deformity. This study aimed at determining the functional outcomes of Percutaneous Achilles Tendon Tenotomy (PAT) vs tendo-Achilles Lengthening (TAL) in the neglected clubfoot children of age 2-5 years.
Despite the increasing use of percutaneous techniques, there is a lack of literature directly comparing the functional outcomes of these two procedures, PAT and TAL. Addressing this knowledge gap is essential to guide pediatric orthopedic surgeons in selecting the most appropriate intervention for the treatment of equinus deformity in neglected clubfoot patients, optimizing functional recovery, minimizing complications, and ultimately improving the quality of care for children with neglected clubfoot.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Percutaneous Achilles Tendon Tenotomy-Group | Patients will be started on serial casting and manipulation according to ponseti method. After successful correction of cavus, varus, and adductus, patients will be treated using the tenotomy of Achilles tendon technique. |
| |
| Tendo-Achilles Lengthening-Group | Patients will be started on serial casting and manipulation according to ponseti method. After successful correction of cavus, varus, and adductus, patients will be treated using the tendo-Achilles Lengthening technique. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Tenotomy of Achilles Tendon | Procedure | Patients will be started on serial casting and manipulation according to ponseti method. After successful correction of cavus, varus, and adductus, patients will be treated using the tenotomy of Achilles tendon technique. |
| Measure | Description | Time Frame |
|---|---|---|
| Improvement in ankle dorsiflexion | Frequency of patients with improvement in ankle dorsiflexion will be noted. | 6 months |
| Measure | Description | Time Frame |
|---|---|---|
| Bleeding | Frequencies of bleeding as none, mild moderate, and severe will be noted. | 1 hour |
| Infection | Frequency of patients who had an infected wound will be noted. |
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Inclusion Criteria:
Exclusion Criteria:
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Newly diagnosed patients of clubfoot between 2 and 5 years of age having Pirani score 3-6 within the study period will be recruited.
| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Pervez Ali, FCPS | Contact | +923333001737 | pervez73@hotmail.com | |
| Sidratul Zaitoon | Contact | +923150012163 | sidra9503@gmail.com |
| Name | Affiliation | Role |
|---|---|---|
| Pervez Ali, FCPS | Jinnah Postgraduate Medical Centre, Karachi, Pakistan | Study Director |
| Sidratul Zaitoon | Jinnah Postgraduate Medical Centre, Karachi, Pakistan | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Jinnah Postgraduate Medical Centre | Recruiting | Karachi | Sindh | 75510 | Pakistan |
Data can be shared on a reasonable request.
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| ID | Term |
|---|---|
| D003025 | Clubfoot |
| ID | Term |
|---|---|
| D000070558 | Talipes |
| D005531 | Foot Deformities, Acquired |
| D005530 | Foot Deformities |
| D009140 | Musculoskeletal Diseases |
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| Tendo-Achilles Lengthening | Procedure | Patients will be started on serial casting and manipulation according to ponseti method. After successful correction of cavus, varus, and adductus, patients will be treated using the Tendo-Achilles Lengthening technique. |
|
| 6 months |
| Incomplete tenotomy | Frequency of patients who will have incomplete release or residual deformity assessed after 6 months. | 6 months |
| D005532 |
| Foot Deformities, Congenital |
| D038061 | Lower Extremity Deformities, Congenital |
| D017880 | Limb Deformities, Congenital |
| D009139 | Musculoskeletal Abnormalities |
| D000013 | Congenital Abnormalities |
| D009358 | Congenital, Hereditary, and Neonatal Diseases and Abnormalities |