PDF(Pubmed)
Abstract：
Percutaneous scalpel tenotomy is frequently performed as part of congenital talipes equinovarus (CTEV) to correct the equinus deformity. The use of a scalpel is associated with complications such as neurovascular bundle damage and pseudoaneurysms. In the literature, a percutaneous large-bore needle has been found to be a safer alternative to a scalpel for performing tenotomies. The goal of this study was to conduct a systematic review and report a single-center case series on the use of percutaneous needle tenotomy in the treatment of CTEV. A Preferred Reporting Items of Systematic Review and Meta-analysis (PRISMA)-compliant literature search was conducted to identify studies describing the use of a percutaneous needle tenotomy in the treatment of idiopathic CTEV. A retrospective case series of patients with idiopathic CTEV treated with percutaneous needle tenotomy over a seven-year period from a single center were also conducted. The patients\' demographics, the location of the clubfoot, and the Pirani score were all recorded. An analysis of descriptive statistics was carried out. Continuous data were expressed as mean and SD, whereas categorical variables were expressed as absolute numbers and percentages (%). The systematic review included eight papers with a total of 1026 feet and a mean age of 10.4 weeks (SD 5.9). There were 47 (0.04%) complications across all studies, with a pooled success rate of 95%. Eleven patients (16 feet) were included in the single-center case study. The patients\' initial Pirani score was 4.8 (SD 1.5), with a final score of 0. (SD 0). Four complications occurred in the patient\'s cohort - one minor bleeding and three recurrences as a result of poor compliance with the post-tenotomy foot abduction brace. In conclusion, the percutaneous Achilles tenotomy of a CTEV foot with a large bore needle is a safe and effective alternative.
摘要：
经皮手术刀张力切开术经常作为先天性马蹄内翻足（CTEV）的一部分进行，以纠正马蹄畸形。手术刀的使用与并发症有关，例如神经血管束损伤和假性动脉瘤。在文学中,已发现经皮大口径针头是进行肌腱切开术的手术刀的更安全的替代方法。这项研究的目的是进行系统评价，并报告一个单中心病例系列，介绍经皮穿刺术在CTEV治疗中的应用。进行了符合系统评价和荟萃分析（PRISMA）的文献检索的首选报告项目，以确定描述经皮穿刺肌腱切开术在特发性CTEV治疗中的应用的研究。还从一个中心进行了为期7年的回顾性病例系列特发性CTEV患者的经皮穿刺术。病人的人口统计学，马蹄足的位置,和皮拉尼评分都被记录下来。进行了描述性统计分析。连续数据以平均值和SD表示，而分类变量表示为绝对数和百分比(%).系统评价包括8篇论文，共1026英尺，平均年龄10.4周（SD5.9）。所有研究中有47例（0.04％）并发症，合并成功率为95%。11名患者（16英尺）被纳入单中心病例研究。患者最初的皮拉尼评分为4.8（SD1.5），最终得分为0。(SD为0)。患者队列中发生了4种并发症-1次轻微出血和3次复发，这是由于对肌腱切开术后足外展支具的依从性差。总之,使用大孔针对CTEV足进行经皮跟腱切开术是一种安全有效的替代方法。
