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Войти в исследования Foot and ankle surgery : official journal of the European Society of Foot and Ankle Surgeons · 2025
Ultrasonographic and elastographic comparison of needle versus scalpel achilles tenotomy in clubfoot: A clinical and morphological study.
СтатьяСравнительное исследованиеМногоцентровое исследованиеНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
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Ошибки и ограничения
История · было → стало
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Alkan Hilmi, Tuncel Candan Yeşim, Üner Çiğdem, Koçyiğit İsmail Aykut, Erdoğan Yasin, Yaşar Niyazi Erdem, Biçici Vedat
Аннотация
BACKGROUND: Achilles tenotomy is an integral component of the Ponseti method for treating congenital talipes equinovarus (CTEV). Although traditionally performed using a scalpel in a sterile setting, percutaneous needle tenotomy has emerged as a minimally invasive alternative. However, comparative evaluations of these techniques using clinical and ultrasonographic parameters remain limited.
METHODS: This retrospective, dual-center study included 145 feet from 95 pediatric patients treated with the Ponseti method between 2022 and 2024. Seventy-two feet underwent percutaneous needle tenotomy, while 73 feet received traditional percutaneous scalpel tenotomy. Demographic characteristics, initial Pirani and Dimeglio scores, maximum dorsiflexion angles, and ultrasonographic findings (tendon thickness, width, length, echotexture, and elastography values) were compared between groups. All ultrasonographic evaluations were performed using standardized protocols and blinded assessment.
RESULTS: There were no significant differences between groups in terms of age, sex, or initial clinical scores (p > 0.05). Tendon stiffness (kPa), shear wave velocity (m/s), and morphologic parameters (thickness, length, and fibril organization) were similar across both groups. Functional outcomes, as assessed by maximum ankle dorsiflexion angle, also did not differ significantly (p > 0.05).
CONCLUSIONS: Percutaneous needle Achilles tenotomy is a safe and effective alternative to percutaneous scalpel tenotomy, yielding comparable clinical, functional, and ultrasonographic outcomes. Both techniques appear equally reliable in terms of tendon healing and biomechanical integrity.
METHODS: This retrospective, dual-center study included 145 feet from 95 pediatric patients treated with the Ponseti method between 2022 and 2024. Seventy-two feet underwent percutaneous needle tenotomy, while 73 feet received traditional percutaneous scalpel tenotomy. Demographic characteristics, initial Pirani and Dimeglio scores, maximum dorsiflexion angles, and ultrasonographic findings (tendon thickness, width, length, echotexture, and elastography values) were compared between groups. All ultrasonographic evaluations were performed using standardized protocols and blinded assessment.
RESULTS: There were no significant differences between groups in terms of age, sex, or initial clinical scores (p > 0.05). Tendon stiffness (kPa), shear wave velocity (m/s), and morphologic parameters (thickness, length, and fibril organization) were similar across both groups. Functional outcomes, as assessed by maximum ankle dorsiflexion angle, also did not differ significantly (p > 0.05).
CONCLUSIONS: Percutaneous needle Achilles tenotomy is a safe and effective alternative to percutaneous scalpel tenotomy, yielding comparable clinical, functional, and ultrasonographic outcomes. Both techniques appear equally reliable in terms of tendon healing and biomechanical integrity.