• Humans
• Clubfoot/surgery
• Clubfoot/therapy
• Tenotomy/methods
• Male
• Female
• Infant
• Retrospective Studies
• Casts, Surgical
• Treatment Outcome
• Heel/surgery
• Follow-Up Studies
• Achilles Tendon/surgery

• clubfoot/diagnosis
• clubfoot/etiology
• clubfoot/surgery
• manipulation orthopedic
• orthopedic procedures

• clubfoot
• congenital talipes equinovarus
• foot deformity
• pediatric orthopedics
• ponsti casting

• Humans
• Muscle Spasticity/surgery
• Neurosurgical Procedures

• Claw toe
• Equinovarus
• Microinvasive surgery
• Muscle hypertonia
• Needle
• Tenotomy

• Child
• Humans
• Infant
• Tenotomy/methods
• Achilles Tendon/surgery
• Clubfoot/surgery
• Pain Management
• Needles
• Treatment Outcome

• clubfoot
• congenital talipes equinovarus
• pain
• sucrose
• talipes
• tenotomy

• Achilles
• CTEV
• Clubfoot
• Local anaesthesia
• Systematic review
• TendoAchilles
• Tenotomy

• Achilles Tendon/diagnostic imaging
• Achilles Tendon/surgery
• Casts, Surgical
• Child
• Child, Preschool
• Clubfoot/diagnostic imaging
• Clubfoot/surgery
• Humans
• Infant
• Prospective Studies
• Tenotomy
• Treatment Outcome

• Achilles Tendon/diagnostic imaging
• Achilles Tendon/surgery
• Calcaneus
• Child
• Clubfoot/diagnostic imaging
• Clubfoot/surgery
• Humans
• Prospective Studies
• Tenotomy

In the 1970s a conservative treatment for clubfoot (CF) deformity based on daily physiotherapy combining specific sequences was developed: the French functional method (FFM). Over time, the FFM technique has improved and additional measures have been introduced. The aim of this study was to report mid-term and long-term results of clubfeet treated conservatively by the FFM at birth.

All patients consecutively treated for clubfoot by the FFM between 1993 and 2010 were prospectively included. Initial severity was assessed by the Dimeglio classification. All patients were followed up by the same treating surgeon until skeletal maturity. Final assessment was performed using the International Clubfoot Study Group evaluation system (ICFSG).

A total of 779 feet were included. Surgery was required in 41% of cases (mean age 2.0±0.1 years). The incidence of surgery significantly decreased after the introduction of percutaneous Achilles tenotomy (PAT) in 2000 (63.4% vs. 29.6%). At latest evaluation (mean follow-up 12±0.2 years), 86% of patients had excellent or good outcomes (mean ICFSG was 1.83±0.1). Mean ankle dorsiflexion was 10° in non-idiopathic CF and 12.1° in idiopathic CF. Eleven percent of the idiopathic clubfeet exhibited decreased ankle function (0–10°). There were no cases of overcorrection into excess ankle dorsiflexion or rocker bottom foot deformities.

Current team was the funding institution of the FFM and several modifications were proposed over times to improve outcomes. Eighty-six percent of feet had excellent to good outcomes according to the ICFSG score, with minimal residual deformities (ankle dorsiflexion between 0° and 10°, calcaneal-thigh angle between 10° and 20°) or insufficient radiological correction (defined by talo-calcaneal angle between 10° and 20°) at latest follow-up.

• Clubfoot (CF)
• French functional method (FFM)
• conservative treatment
• physiotherapy

An Achilles tenotomy is routinely required to correct the equinus deformity in Congenital talipes equinovarus (CTEV) patients as part of the gold standard treatment using the Ponseti method. This procedure can be performed in clinic under local anaesthetic or in theatre under general anaesthetic. The COVID-19 pandemic reduced theatre capacity and caused a delay to CTEV patients’ treatment. A new standard operating procedure that allowed the tenotomies to be performed under local anaesthetic in the clinic was introduced. This study was looking into the safety, feasibility and parents’ perspective of this procedure.

The study was prospectively registered as a service improvement project and followed the SQUIRE guidelines (Ogrinc et al. in BMJ Qual Saf 25:986–992, 2016). All consecutive patients requiring a tenotomy were included. Data was collected prospectively including demographics, Pirani score and a carers’ satisfaction questionnaire.

Twenty five patients (36 tenotomies) were included in the study. The median age was 9 weeks. All patients achieved ankle dorsiflexion of greater than 15° post-op. None of the patients nor their parents contracted the COVID 19 virus. All parents reported a positive experience and 99% felt less anxious about having the tenotomy done in clinic rather than theatre.

The new service offering clinic tenotomies was found to be safe and clinically successful. This study is the first to show parents preference and excellent satisfaction with a tenotomy performed under local anaesthetic. The service has improved the allocation of resources and due to its success, will continue beyond the pandemic.

The online version contains supplementary material available at 10.1007/s00264-021-05119-w.

• COVID-19
• Clubfoot
• Local anaethesia
• Tenotomy

• COVID-19
• Casting
• Clubfoot
• Congenital talipes equinovarus
• Ponseti
• Tenotomy

• Accelerated Ponseti technique
• Idiopathic congenital clubfoot
• Pirani score

• Achilles Tendon/surgery
• Ankle Joint/surgery
• Casts, Surgical
• Clubfoot/surgery
• Female
• Humans
• Infant
• Infant, Newborn
• Male
• Tenotomy/methods
• Treatment Outcome

The “Wide Awake Local Anesthesia No Tourniquet” (WALANT) technique is gaining popularity in hand surgery owing to its benefits of reduced cost, shorter hospital stay, improved safety, and the ability to perform active intraoperative examinations. The aim of this study is to analyze the cost savings and efficiency of performing A1 pulley release for treatment of trigger finger using the WALANT technique in a major city hospital procedure room (PR) as compared with the standard tourniquet, operating room (OR) approach.

• Early onset scoliosis (EOS)
• Infantile scoliosis
• Serial casting
• Syndromic-associated EOS

• Clubfoot
• complete percutaneous tenotomy of tendoachillis
• ponseti method

• Botulinum Toxins, Type A
• Clubfoot
• Double-Blind Method
• Foot
• Humans
• Needles

• WALANT
• ambulatory surgery
• epinephrine
• in-office procedure room
• tourniquet
• wide-awake anesthesia

• Ambulatory Surgical Procedures
• Anesthesia, Local
• Anesthetics, Local/administration & dosage
• Cost-Benefit Analysis
• Epinephrine/administration & dosage
• Hand/surgery
• Humans
• Lidocaine/administration & dosage
• Orthopedic Procedures
• Patient Safety
• Patient Satisfaction

The aim of this study was to compare the efficacy, advantages, and complications of percutaneous achillotomy in the treatment of clubfoot with the Ponseti method when performed to two different groups under general anesthesia or polyclinic conditions with local anesthesia.

A retrospective evaluation was made of 96 patients treated for clubfoot in our clinic between January 2013 and June 2016. Fifty-seven patients were separated into two groups according to whether the achillotomy was performed in polyclinic conditions with local anesthesia or under general anesthesia following serial plaster casting with the Ponseti method.

The characteristics of age distribution, mean week of tenotomy, side, and sex were similar in both groups. No statistically significant difference was determined between the two groups in respect to complication and recurrence. The durations of hospitalization-observation, separation from the mother, and fasting were found to be statistically significantly shorter in local anesthesia group.

Although the performance of percutaneous achillotomy with local or general anesthesia has different advantages, it can be considered that especially in centers with high patient circulation, achillotomy with local anesthesia can be more preferable to general anesthesia because it is practical and quick, does not require a long period of fasting or hospitalization, and has a similar complication rate to general anesthesia procedures.

• Achillotomy
• Clubfoot
• Ponseti

• Ponseti
• clubfoot
• heel cord
• tenotomy

• Ambulatory surgery
• Day surgery
• Pediatrics orthopedic surgery
• Perioperative pathways
• Regional anesthesia

• Achilles tenotomy
• Clubfoot
• Mini-open
• Ponseti
• TAL

Twenty-two percent of institutionalised elderly persons have muscle contractures. Contractures have important functional consequences, rendering hygiene and positioning in bed or in a chair difficult. Medical treatment (such as botulinum toxin injections, physiotherapy or positioning) is not very effective and surgery may be required. Surgery is carried out in the operating theatre, under local or general anaesthesia but is often not possible in fragile patients. Mini-invasive tenotomy could be a useful alternative as it can be carried out in ambulatory care, under local anaesthesia.

To evaluate the effectiveness of percutaneous needle tenotomy and the risks of damage to adjacent structures in cadavers.

Thirty two doctors who had never practiced the technique (physical medicine and rehabilitation specialists, geriatricians and orthopaedic surgeons) carried out 401 tenotomies on the upper and lower limbs of 8 fresh cadavers. A 16G needle was used percutaneous following location of the tendons. After each tenotomy, a neuro-orthopaedic surgeon and an anatomist dissected the area in order to evaluate the success of the tenotomy and any adjacent lesions which had occurred.

Of the 401 tenotomies, 72% were complete, 24.9% partial and 2.7% failed. Eight adjacent lesions occurred (2%): 4 (1%) in tendons or muscles, 3 (0.7%) in nerves and 1 (0.2%) in a vessel.

This percutaneous needle technique effectively ruptured the desired tendons, with few injuries to adjacent structures. Although this study was carried out on cadavers, the results suggest it is safe to carry out on patients.

The Ponseti method has become the gold standard for the treatment of idiopathic clubfoot. Its safety and efficacy has been demonstrated extensively in the literature, leading to increased use around the world over the last two decades. This has been demonstrated by the increase in Ponseti related PubMed publications from many countries. We found evidence of Ponseti activity in 113 of 193 United Nations members. The contribution of many organizations which provide resources to healthcare practitioners in low and middle income countries, as well as Ponseti champions and modern communication technology, have helped to spread the Ponseti method around the world. Despite this, there are many countries where the Ponseti method is not being used, as well as many large countries in which the extent of activity is unknown. With its low rate of complication, low cost, and high effectiveness, this method has unlimited potential to treat clubfoot in both developed and undeveloped countries. Our listing of countries who have not yet shown presence of Ponseti activity will help non-governmental organizations to target those countries which still need the most help.

• Ponseti
• Clubfoot
• World
• Organization
• Children

• Achilles Tendon/surgery
• Braces
• Casts, Surgical
• Clubfoot/surgery
• Humans
• Manipulation, Orthopedic
• Range of Motion, Articular
• Tenotomy