Joint lengthening of the flexor hallucis longus and flexor digitorum longus in the surgical treatment of congenital clubfoot: a tenodesis technique
Keywords:
Congenital Talipes Equinovarus, Stretching, Surgical TechniqueAbstract
Introduction: The congenital talipes equinovarus (CTEV), often known as clubfoot, has been a severe orthopaedic disorder of the newborn infant. For the treatment of this condition the surgical technique that is called extended posteromedial release has been used. This article shows the results of a modified step of this technique using the elongation of the flexor tendons, flexor hallucis longus and flexor digitorum longus in a conjoint way.
Methods: This is a descriptive observational study of serial cases that were treated between 1995 and 2005 at Hospital Universitario San Jorge de Pereira, Colombia. The evaluation has been made by measuring the power of the flexor tendons and the walking efficiency in a 2 years minimum follow-up period.
Results: 30 patients were included, half of them with a bilateral disease. The average age at operation time was less than a year in close to 80%. The average of follow-up was 5 years. The evaluation of strength and efficacy of flexion of the fingers and functional walking ability was good for the whole group.
Discussion: The flexor tendons are small and their individual elongation is difficult, leaving long surfaces of scar and fibrosis. With this technique we avoid these problems leaving zones of sliding clear, and allowing the synergism of the tendons, assuring their good function in the future. We recommend the use of this technique during the surgical treatment of the CTEV.
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