Comparison of three different methods of anterior tibial tendon transfer for relapsed clubfoot: A pilot study

Anil Agarwal; Gourav Jandial; Neeraj Gupta

doi:10.1016/j.jcot.2018.09.001

Comparison of three different methods of anterior tibial tendon transfer for relapsed clubfoot: A pilot study

J Clin Orthop Trauma. 2020 Mar-Apr;11(2):240-244. doi: 10.1016/j.jcot.2018.09.001. Epub 2018 Sep 7.

Authors

Anil Agarwal¹, Gourav Jandial¹, Neeraj Gupta¹

Affiliation

¹ Department of Paediatric Orthopaedics, Chacha Nehru Bal Chikitsalaya, Geeta Colony, Delhi, 110031, India.

Abstract

Introduction: The commonly techniques for anterior tibial tendon transfer (ATTT) for clubfoot are split transfers (Hoffer), whole transfers to cuboid (Garceau) or 3rd cuneiform (Ponseti). We compared these surgical ATTT methods for relapsed clubfoot.

Material and methods: Thirty relapsed clubfoot (46 feet) patients initially treated with Ponseti casting technique were prospectively randomized for ATTT techniques. The outcome was evaluated in terms of foot inversion, eversion and ankle dorsiflexion.

Results: Average follow up was 5.49 months. Whole transfers had better absolute ankle dorsiflexion than split transfers. Foot inversion was comparable in Hoffer and Ponseti transfers but better with Garceau transfers. For eversion, best values occurred with Ponseti transfers. Absolute values of ankle dorsiflexion, foot inversion and eversion obtained with spilt transfers were less than those obtained with whole transfers (statistically insignificant).

Conclusions: No significant differences for foot or ankle function could be detected in this study using the various surgical ATTT techniques in short term follow up.

Keywords: Anterior tibial tendon; Clubfoot; Dynamic supination; Relapse; Tendon transfer.