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Lateral tibiocalcaneal angle seen as better indicator than dorsiflexion angle for Achilles tenotomy
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Recently published data indicate the lateral tibiocalcaneal angle as viewed on radiograph was a better prognostic indicator than the ankle dorsiflexion angle analyzed via physical examination in determining the need for percutaneous Achilles tenotomy in patients with idiopathic clubfoot.
Researchers identified 82 patients who underwent treatment for 125 idiopathic clubfeet. Mean follow-up was 48.5 months. Clubfeet were into categorized into one of the following four groups by their lateral tibiocalcaneal and the ankle dorsiflexion angles: group A had both favorable lateral tibiocalcaneal (equal to or less than 80°) and ankle dorsiflexion (equal to or greater than 15°) angles; group B had a favorable lateral tibiocalcaneal angle and an unfavorable ankle dorsiflexion angle (less than 15°); group C had an unfavorable lateral tibiocalcaneal angle (greater than 80°) and favorable ankle dorsiflexion angle; and group D had both unfavorable angles. Researchers decided whether to perform percutaneous Achilles tenotomy based on clinical outcomes and the prognostic impact of angle-based decisions.
Findings showed the initial correction of deformity in all patients was successful. Patients did not experience sagittal relapse or surgery when the lateral tibiocalcaneal angle was favorable; whereas 13.7% of patients in group A and 9.8% of patients in C (both of which had favorable ankle dorsiflexion angles), experienced sagittal relapse or surgery. According to researchers, the lateral tibiocalcaneal angle-based decision was an independent prognostic determinant for both sagittal relapse and surgery. ‒ by Monica Jaramillo
Disclosures: The researchers report no relevant financial disclosures.
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