Percutaneous Achilles Tenotomy with a Large Gauge Needle in Ponseti Management of CTEV: A Modified TechniqueCorrespondence Address :
Dr. Ritesh Arvind Pandey,
Assistant Professor, Department of Orthopaedics, Christian Medical College and Hospital,
Brown Road, Ludhiana, Punjab-141008, India.
Introduction: Tenotomy of Tendo-Achilles for clubfoot deformity is routinely done percutaneously with a surgical blade. This method though safe and effective, carries risk of complications such as excessive bleeding and injury to nearby neurovascular structures. Alternatively, sectioning of Achilles tendon can be done safely by a large gauge needle percutaneously.
Aim: To study the safety and effectiveness of modified technique.
Materials and Methods: A total of 37 children with 51 congenital clubfoot were included in this observational study. After successful correction of forefoot adduction and heel varus using the Ponseti technique, Tendo-Achilles was sectioned percutaneously with a 16/18 gauge needle. Any complication occurring during the procedure was noted. Completeness of the tenotomy was checked by Thompson’s test and gain in passive dorsiflexion at ankle.
Results: Complete division of tendon was achieved in all 51 feet. No incidence of excessive bleeding, neurovascular injury or formation of pseudoaneurysm was found. However, minor bleeding from the surgical site was noticed in three cases and was managed by applying mild pressure over the involved area.
Conclusion: Percutaneous tenotomy of Tendo-Achilles with a wide gauge needle is simple, safe and effective technique. It causes less morbidity and carries lesser risk of complications when compared to a surgical blade.
Clubfoot, Equinus, Tendo-Achilles
Ritesh Arvind Pandey, Bobby John. PERCUTANEOUS ACHILLES TENOTOMY WITH A LARGE GAUGE NEEDLE IN PONSETI MANAGEMENT OF CTEV: A MODIFIED TECHNIQUE. Journal of Clinical and Diagnostic Research [serial online] 2017 November [cited: 2017 Nov 19 ]; 11:RC01-RC04. Available from
Date of Submission: May 15, 2017
Date of Peer Review: Jul 17, 2017
Date of Acceptance: Sep 06, 2017
Date of Publishing: Nov 01, 2017
FINANCIAL OR OTHER COMPETING INTERESTS: None.
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