Alternative Methods of Fixation for Anterior Tibialis Transfer in Residual Clubfoot Deformity

• DOI: 10.1016/j.jposna.2024.100126
• Publication Date: 2024-10-03T16:07:37Z
• Authors: Spencer Wilson; Laura L. Bellaire; Kenneth J. Noonan
• Keywords: Orthopedic surgery; Clubfoot; 03 medical and health sciences; 0302 clinical medicine; Pediatrics; Anterior tibialis transfer; RD701-811; RJ1-570; Ponseti

The preferred treatment for congenital clubfoot is the Ponseti method, which involves weekly manipulation and casting followed by tendoachilles tenotomy abduction bracing. Depending on patient age deformity location, 5%-35% of patients experience recurrent deformities require additional treatment, including or surgery. Dynamic supination during swing phase gait represents a common sequela; it can be managed with anterior tibialis transfer to lateral foot. Variations in this technique include how much tendon transferred, use 2 3 incisions, recipient location transferred tendon, fixation methods. entire into ossified 3rd cuneiform securing absorbable stitches tied over plantar button sterile felt. With senior author has had soft tissue complications, namely skin maceration and, one occasion, full-thickness necrosis down fascia. As result, variations have evolved resultant mitigation these complications. These methods are described here. (1)Anterior (ATT) commonly utilized method addressing residual following method(2)The classic includes using an suture felt under cast. While uncommon, lead significant pressure sores.(3)For who undergo isolated ATT, we now tie outside cast avoid sore.(4)In ATT posterior contracture, secure site tying K-wire used maintain hindfoot correction.