Techniques, anaesthesia preferences, and outcomes of Achilles tenotomy during Ponseti method of idiopathic clubfoot correction: A systematic review.
Techniques, anaesthesia preferences, and outcomes of Achilles tenotomy during Ponseti method of idiopathic clubfoot correction: A systematic review.
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DOI：
10.1016/j.foot.2022.101922
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发表时间：
2022-09-01
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影响因子：
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通讯作者：
Sudesh, Pebam
中科院分区：
文献类型：
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作者：
Rangasamy, Karthick;Baburaj, Vishnu;Sudesh, Pebam
背景技术背景：跟腱切开术（AT）是Ponseti铸造方法的一个重要方面，在80-90%的特发性马蹄内翻足病例中进行，以纠正残留的后足马蹄足。文献中描述了不同的技术，但不清楚哪种方法更上级。本综述旨在分析所描述的各种技术，麻醉偏好和AT的结局。方法：我们检索了PubMed，Embase，Scopus和奥维德MEDLINE中描述原发性马蹄内翻足病例在Ponseti铸造法期间接受原发性AT的文章。从合格的研究中提取数据进行定性和定量合成。结果：共纳入19篇文献进行系统评价。在大多数情况下，使用手术刀或针进行经皮AT是足够的，并显示出有希望的结果。门诊（OPD）局部麻醉（LA）下肌腱切断术和手术室（OR）全身麻醉（GA）下肌腱切断术的重复肌腱切断率分别为2.5%（95%CI，0.4 -5.4%）和0.8%（95%CI，0-1.6%）。OPD和OR组之间的差异无统计学显著性（p=0.875）。汇总分析显示失败/复发率为4.2%（1.9- 6.4%，p
BACKGROUND: Achilles tenotomy (AT) forms an important aspect of Ponseti's casting method and is performed in 80-90% of idiopathic clubfoot cases to correct residual hindfoot equinus. Different techniques are described in the literature with no clarity on which method is superior. This review aims to analyse the various techniques described, anaesthesia preferences, and outcomes of AT.METHODS: We searched PubMed, Embase, Scopus, and Ovid MEDLINE for articles describing idiopathic clubfoot cases undergoing primary AT during Ponseti's casting method. Data were extracted from eligible studies for qualitative and quantitative synthesis. The repeat tenotomy and complication rates were taken as outcome parameters.RESULTS: Nineteen studies were included for systematic review. A percutaneous AT using a scalpel or needle is adequate in most cases and shows promising results. The out-patient department (OPD) tenotomies under local anaesthesia (LA) and operation room (OR) tenotomies under general anaesthesia (GA) were associated with a repeat tenotomy (RT) rate of 2.5% (95%CI,0.4-5.4%) and 0.8% (95%CI, 0-1.6%), respectively. The difference between OPD and OR groups was not statistically significant (p=0.875). The pooled analysis shows a failure/relapse rate of 4.2% (1.9-6.4%, p