Rate and predictors of relapse and surgery in idiopathic clubfeet after successful Ponseti treatment in infancy : a single centre, retrospective, comparative study.

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Abstract

Conflict of interest statement: M. Bouchard reports consulting fees for Orthopediatrics and Orthopediatrics Specialty Bracing; payments for speaking at Washington University, Cincinnati Children's Hospital, and Columbia University; and a hotel for the annual IPOS meeting, paid for by the Pediatric Orthopaedic Society of North America; and is cofounder of Orthoflexion, all of which are unrelated to this work. 3. BMC Musculoskelet Disord. 2024 Aug 12;25(1):638. doi: 10.1186/s12891-024-07621-9. Anterior tibial tendon transfer in idiopathic clubfoot: pull-out vs. other fixations - a systematic review. Moreira A(1), Benjamin Ravetti L(2), Carrapeiro Prina D(3), Paschoal Nogueira M(4)(5). Author information: (1)Hospital Pedro Hispano, ULS Matosinhos, Portugal, Matosinhos, Portugal. (2)Hospital Universitario Austral, Buenos Aires, Argentina. (3)Hospital do Servidor Publico Estadual de São Paulo, Sao Paulo, SP, Brazil. (4)Hospital do Servidor Publico Estadual de São Paulo, Sao Paulo, SP, Brazil. monipn@uol.com.br. (5)Núcleo de Apoio à Pesquisa Ortopédica Avançada (NAPOA), Sao Paulo, SP, Brazil. monipn@uol.com.br. PURPOSE: Review the literature and describe the complications associated with each of the anterior tibial tendon transfer (ATTT) techniques described. METHODS: A systematic review of the literature was performed with the keywords ''clubfoot'', ''Ponseti'' and ''anterior tibial''. Studies in patients with clubfoot recurrence, who underwent ATTT, whose method of tendon fixation was different from the classical method, were included. RESULTS: Six studies were included in this systematic review, which described multiple techniques for tibialis anterior fixation: bone anchors, interference screws, endobotton, K-wires, transosseous suture, and suture to the plantar fascia. In the papers that described postoperative complications, no major complications were reported, however the samples are generally small. CONCLUSION: Several options have now emerged for tendon fixation in tendon transfers around the foot and ankle, including ATTT for treatment of relapsed clubfoot. To our knowledge this is the first paper that questioned the potential complications associated with the use of these new techniques. Due to the scarcity of published works in favor of other fixation methods, we believe that the traditional method is the optimal one for the transfer of the tendon of the tibialis anterior muscle. © 2024. The Author(s). DOI: 10.1186/s12891-024-07621-9 PMCID: PMC11318294