Abstract | INTRODUCTION: A relapsed idiopathic clubfoot can be effectively treated with transfer of the entire tibialis anterior tendon to the mid-dorsum of the foot following repeated manipulations and serial casts. STEP 1 PREOPERATIVE PLANNING: Ensure that the foot has been adequately corrected for tendon transfer by performing both clinical and radiographic evaluation. STEP 2 PREPARE THE PATIENT: STEP 3 IDENTIFY AND RELEASE THE TIBIALIS ANTERIOR TENDON FROM ITS INSERTION: Identify the tibialis anterior tendon and release its insertion on the medial cuneiform and first metatarsal bones. STEP 4 PREPARE THE TENDON AND SURROUNDING TISSUES FOR TRANSFER: Release obstructing tissues and prepare the freed tendon for lateral transfer to the mid-dorsum of the foot. STEP 5 PREPARE THE LATERAL CUNEIFORM FOR TENDON TRANSFER AND FIXATION: Identify the lateral cuneiform with fluoroscopy and prepare it for transfer of the tibialis anterior tendon. STEP 6 TRANSFER AND SECURE THE TENDON: Make a subcutaneous path, transfer the tendon, and secure it in the osseous tunnel of the lateral cuneiform. STEP 7 POSTOPERATIVE CARE: We apply a long leg cast and restrict patients to non-weight-bearing for six weeks. RESULTS: The tibialis anterior tendon transfer has been used to treat relapsing idiopathic clubfoot with great success for more than fifty years.IndicationsContraindicationsPitfalls & Challenges.
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Authors | Joshua B Holt, Brian Westerlind, Jose A Morcuende |
Journal | JBJS essential surgical techniques
(JBJS Essent Surg Tech)
Vol. 5
Issue 3
Pg. e16
(Sep 23 2015)
ISSN: 2160-2204 [Print] United States |
PMID | 30473924
(Publication Type: Journal Article)
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