Percutaneous Achilles Tenotomy in Idiopathic Clubfoot treatment
Selmani E et al. - Percutaneous Achilles Tenotomy in Idiopathic Clubfoot treatment


posteromedial release

How to Cite

Selmani, E., Ruci, J., & Gjonej, A. (2023). Percutaneous Achilles Tenotomy in Idiopathic Clubfoot treatment. Albanian Journal of Trauma and Emergency Surgery, 7(1), 1104-1106.


Introduction; Percutaneous Achilles tenotomy is a standard procedure in most clubfoot patients treated with Ponseti method as the most widely use method of conservative clubfoot treatment. To our knowledge, there are not studies published in Albanian literature about this technique. Our goal is to present results of conservative treatment of idiopathic clubfoot where this technique was performed.

Material and Method. This is a prospective study of all idiopathic clubfoot patients treated in our Institution with Ponseti Method. We performed this technique under sedation anesthesia in operation room, not in clinic. We measured age of patient at time of presentation, gravity according to Pirani score, number of casting, need for Achilles tenotomy).

We measured the degree of angle of dorsiflexion before and after this procedure, the gravity and need for a second procedure.

Results: Out 400 clubfeet treated during 2005-2010 we included in our study 372 case that needed the percutaneous Achilles tenotomy performed. Average age at presentation was 3 weeks. Average Pirani score was 5.5. The number of weekly serial cast needed before the tenotomy was 8. Dorsiflexion angle after this procedure was improved by 45 degree (range from 30 to 90 degree). Only 2 cases needed reoperation due to non-compliance with foot abduction bar and physiotherapy

Conclusion: The percutaneous Achilles tenotomy is used in 93% of case with idiopathic clubfoot serie of patient. It is an easy technique performed with sedation anesthesia in operation room not with local anesthesia. Achilles tenotomy is an important element to avoid recurrence This supports other studies that have used this method.
Selmani E et al. - Percutaneous Achilles Tenotomy in Idiopathic Clubfoot treatment


RJ Cummings and WW Lovell: Operative treatment of congenital idiopathic club foot J. Bone Joint Surg. Am., Aug 1988; 70: 1108 - 1112.

AD Green and GC Lloyd-Roberts. The results of early posterior release in resistant club feet. A long-term review. J Bone Joint Surg Br, Aug 1985; 67-B: 588 - 593.

PM Hutchins, BK Foster, DC Paterson, and EA Cole. Long-term results of early surgical release in club feet. J Bone Joint Surg Br, Nov 1985; 67-B: 791 - 799.

J. H. Kite Principles Involved in The Treatment of Congenital Club-Foot J. Bone Joint Surg. Am., Jul 1939; 21: 595 - 606.

Levin MN, Kuo KN, Harris GF, Matesi DV. Postero-medial release for idiopathic talipes equinovarus. A long-term follow-up studies. Clin Orthop Relat Res. 1989 May;(242):265-8.

McKay DW New concept of and approach to clubfoot treatment: Section III--evaluation and results. J Pediatr Orthop. 1983 May;3(2):141-8.

Nather A, Bose K Conservative and surgical treatment of clubfoot. J Pediatr Orthop. 1987 Jan-Feb;7(1):42-8.

Porat S, Milgrom C, Bentley G . The history of treatment of congenital clubfoot at the Royal Liverpool Children's Hospital: improvement of results by early extensive posteromedial release. J Pediatr Orthop. 1984 May;4(3):331-8.

VJ Turco Resistant congenital club foot--one-stage posteromedial release with internal fixation. A follow-up report of a fifteen-year experience J. Bone Joint Surg. Am., Sep 1979; 61: 805 - 814.

SJ Laaveg and IV Ponseti. Long-term results of treatment of congenital club foot

J. Bone Joint Surg. Am., Jan 1980; 62: 23 - 31.

DM Cooper and FR Dietz. Treatment of idiopathic clubfoot. A thirty-year follow-up note

J. Bone Joint Surg. Am., Oct 1995; 77: 1477 - 1489.

Flynn JM, Donohoe M, Mackenzie WG. An independent assessment of two clubfoot-classification systems. J Pediatr Orthop. 1998 May-Jun;18(3):323-7.

IV Ponseti Treatment of congenital club foot J. Bone Joint Surg. Am., Mar 1992; 74: 448 – 454

Ponseti IV, Campos J. Observations on pathogenesis and treatment of congenital clubfoot. Clin Orthop Relat Res. 1972 May; 84:50-60.

Ignacio V. Ponseti, R. Jay Cummings, Richard S. Davidson, Peter F. Armstrong, and Wallace B. Lehman The Ponseti Technique for Correction of Congenital Clubfoot

J. Bone Joint Surg. Am., Oct 2002; 84: 1889 - 1891.

Heilig MR, Matern RV, Rosenzweig SD, Bennett JT Current management of idiopathic clubfoot questionnaire: a multicentric study. J Pediatr Orthop. 2003 Nov-Dec; 23(6):780-7.

E. Ippolito, P. Farsetti, R. Caterini, and C. Tudisco. Long-Term Comparative Results in Patients with Congenital Clubfoot Treated with Two Different Protocols

J. Bone Joint Surg. Am., Jul 2003; 85: 1286 – 1294

Abdelgawad AA, Lehman WB, van Bosse HJ, Scher DM, Sala DA Treatment of idiopathic clubfoot using the Ponseti method: minimum 2-year follow-up. J Pediatr Orthop B. 2007 Mar;16(2):98-105.

Radler C, Suda R, Manner HM, Grill F. Early results of the Ponseti method for the treatment of idiopathic clubfoot. Z Orthop Ihre Grenzgeb. 2006 Jan-Feb;144(1):80-6.

Kite JH. The clubfoot. New York: Grune & Stratton, 1964

Zimbler S. Nonoperative management of the equionovarus foot: long term results. In Simons GW, ed. The clubfoot.New York: Springer Verlag.1994: 191-3

Shaw NE. The early management of clubfoot. Clin.Orthop.1972; 84:39-43

Vesely DG, A method of application of clubfoot cast. Clin.Orthop. 1972; 84:47-9

Kite JH. Nonoperative treatment of congenital clubfoot. Clin.Orthop. 1972; 84: 29-38

Morcuende JA, Dolan LA, Dietz FR, Ponseti IV. Radical reduction in the rate of extensive corrective surgery for clubfoot using Ponseti method. Pediatrics.2004; 113: 376-80

Haft GF, Walker CG, Crawford HA. Early clubfoot recurrence after use of the Ponseti method in a New Zealand population. J Bone Joint Surg. Am. 2007;89 :487-93

Matthew B. Dobbs, J.R. Rudzki, Derek B. Purcell, Tim Walton, Kristina R. Porter, and Christina A. Gurnett Factors Predictive of Outcome After Use of the Ponseti Method for the Treatment of Idiopathic Clubfeet J. Bone Joint Surg. Am., Jan 2004; 86: 22 – 27

Selmani, E. Is Ponseti's method superior to Kite's for clubfoot treatment he? Eur Orthop Traumatol 3, 183–187 (2012).

Gjonej, A., Gjonej, R., Selmani, E. and Çaushi, G., 2014. Results of Clubfoot Treatment with Kite Method. International Journal of Orthopaedics, 1(3), pp.116-119.

Gjonej, A., R. Gjonej, and E. Selmani. "Clubfoot since Ancient Time Up to Now. J Ost Arth 1: 108." of 3 (2016): 3-26.

Creative Commons License

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.