Syed Dil Bagh Ali Shah, Adnan Khan, Syeda Umm-e habiba Gillani, Zaffar Durrani.
Incidence of Achilles Tenotomy in Management of Congenital Equino Varus (Ctev) by Ponseti Casting Technique in Neonates.
Ophthalmol Update Jun ;13(1):26-8.

Objective: The purpose of this study is to evaluate the incidence of surgery i.e. tenotomy in Ponseti technique in the management of congenital Talipes Equino Varus (CTEV). Methods: It is a prospective observational study, conducted during the period of Feb., 2014 to Sept., 2014 at the Department of Orthopedic Surgery Khyber Teaching Hospital Peshawar. All the neonates with CTEV were treated with Ponseti casting technique. Neonates with other congenital deformities, arthrogryposis and myelomeningocele were excluded. Results: Total 37 CTEV feet of 17 neonates were treated. Seventeen were males and four female. Seventeen patients had bilateral and 4 had unilateral involvement. Mean number of plaster casts required per CTEV was 6.50 (range: 6-7). 21/37 (60%) feet required percutaneous tenotomy of Achilles tendon. Conclusion: The Ponseti technique is an excellent, simple, effective, minimally invasive, and inexpensive procedure for the treatment of CTEV deformity. Ideally it can be performed as a day case procedure without general anesthesia even in neonatal period. Percutaneous tenotomy of Achilles tendon is usually needed in the patients who need more number of plasters to correct the initial deformity.

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