Tibialis Anterior Tendon Transfer for Correction of Residual Dynamic Supination of Clubfoot Treated with Ponseti Technique

Abstract

Background: relapsed Clubfoot has been a clinical challenge for the orthopedic surgeons. There is no single modality of treatment till date. Tibialis anterior tendon transfer was described as a good procedure in restoring muscle balance and correcting this deformity. Aim of the work: to evaluate the results of tibialis anterior tendon transfer after walking age in children with residual dynamic supination after correction of congenital clubfoot with ponseti technique. Patients and methods: The current study is an interventional study that was conducted between 2016 and 2019 at Benha University hospitals, Zagazig general hospital, and Zagazig university hospitals. About (30 feet) in 22 patients with residual dynamic clubfoot deformity underwent transfer of the anterior tibial tendon were enrolled in the study. The follow up period ranged from 12 months to 19 months. Results: The patients' age ranged from 2.5 years to 6.5 years old at the time of the operation with mean age was (4.22±1.26) and the majority of them were males (60%). About 9 feet (30%) required further preoperative recasting and tendoachilles lengthening. There was statistically significant improvement between pre and post operative results regarding observational gate analysis, range of motion, foot posture index, X ray measured angles, eversion muscles power and parents satisfaction (p value <0.05). Conclusion: Tibialis anterior tendon transfer has been shown to be an effective procedure in dynamic supination deformity correction. Ankle and foot range of motion and muscle function of the children definitely improved with the procedure.

Split Tibialis Anterior Transfer for Correction of Residual Dynamic Metatarsus Adductus Following Ponseti Management of Idiopathic Clubfoot

“…On the other hand, the bilateral cases were 4 cases (22.2%) out of the 18 patients. This is compared with Abdelkhalik et al (9) who had fourteen patients (63.6%) had unilateral affection while 8 patients (36.3%) had bilateral affection. Kuo et al (10) had all his cases with unilateral with no bilateral cases.…”