Ultrasound Assessment of Achilles Tendon-Neurovascular Distance in Infants With Unilateral Clubfoot
For patients and families
In plain language
An automatic summary of structured registry data. It is an orientation aid, not a substitute for the official protocol or a physician assessment.
- What is being studied
- The protocol lists: ultrasound.
- Who it may be relevant to
- Registry conditions: Clubfoot. Basic parameters: 1 months — 6 months · All.
- What needs checking
- Age, condition and sex are only basic indicators. Prior treatment, laboratory values and other mandatory requirements appear in the eligibility criteria below.
- Where it takes place
- Center list to be confirmed — check the primary protocol.
- Next step
- Save the trial, show it to the treating physician, and confirm current recruitment with the study center. Costs, documents and travel →
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Official title
Measurement of Achilles Tendon-neurovascular Distance Bilaterally in Infants With Unilateral Clubfoot Deformity
Overview
This study aims to assess the distance between the Achilles tendon and nearby neurovascular bundles bilaterally in infants with unilateral clubfoot deformity using ultrasound (US)- Doppler at 1 cm and 2 cm above the calcaneal tuberosity.
Detailed description
Idiopathic clubfoot is a congenital deformity affecting the musculoskeletal structure of the foot .The Ponseti method remains the gold standard for its correction, culminating with a percutaneous Achilles tenotomy (1). Treatment of clubfoot with the Ponseti method has improved anatomical and functional results and reduced the number of surgical interventions required (4,7). In 80-90% of cases, a percutaneous tenotomy of the Achilles tendon is needed at 3-4 months of age, if the equinus position of the foot persists after corrective casts, and if the dorsiflexion of the ankle is less than 10º (7). The surgery is often performed as an outpatient procedure under local anesthesia and seems to be low risk. However, a complication rate of up to 4 % has been recorded , and the complications include pseudoaneurysm, necrosis, or gangrene of the foot that underwent intervention (7). The safety of this procedure critically depends on the spatial relationship between the Achilles tendon and adjacent neurovascular structures (6). Our objective is to study the use of ultrasound (US)- Doppler before Achilles tendon tenotomy bilaterally to determine the distance between the tendon and the posterior tibial neurovascular bundle in infants with unilateral clubfoot .
Interventions
- Device ultrasound
This study aims to assess the distance between the Achilles tendon and nearby neurovascular bundles bilaterally in infants with unilateral clubfoot deformity using ultrasound (US)- Doppler at 1 cm and 2 cm above the calcaneal tuberosity.
Primary outcome measures
- To measure the distance between the Achilles tendon and: • The posterior tibial neurovascular bundle In the clubfoot vs the normal foot [Time frame: baseline]
Eligibility criteria
Inclusion criteria
- Infants aged 1-6 months
- Unilateral clubfoot deformity and a normal opposite foot
Exclusion criteria
- Non-idiopathic or syndromic clubfoot
- Previous foot surgery , contralateral foot deformity
Criteria are shown verbatim from the registry (in English). Final eligibility is always assessed by the study center.
Healthy volunteers: No
Study design
- Observational model
- Other
Study locations
Center list to be confirmed — check the primary protocol.
Publications
- Gutierrez Carbonell P, Navarro Amoros M, Ojeda Pena M, Pellicer Garcia V, Moril Penalver L. Ultrasound (US) measurement of the distance between the Achilles tendon and the posterior tibial neurovascular bundle in equinus infantile deformity. Skeletal Radiol. 2014 Jun;43(6):801-4. doi: 10.1007/s00256-014-1847-0. Epub 2014 Mar 13. PMID 24622926
- Hootnick DR, Packard DS Jr, Levinsohn EM. Necrosis leading to amputation following clubfoot surgery. Foot Ankle. 1990 Jun;10(6):312-6. doi: 10.1177/107110079001000605. PMID 2358260
- Dobbs MB, Gordon JE, Walton T, Schoenecker PL. Bleeding complications following percutaneous tendoachilles tenotomy in the treatment of clubfoot deformity. J Pediatr Orthop. 2004 Jul-Aug;24(4):353-7. doi: 10.1097/00004694-200407000-00002. PMID 15205614
- Jaszberenyi Z, Moriggi L, Schmidt P, Weidensteiner C, Kneuer R, Merbach AE, Helm L, Toth E. Physicochemical and MRI characterization of Gd3+-loaded polyamidoamine and hyperbranched dendrimers. J Biol Inorg Chem. 2007 Mar;12(3):406-20. doi: 10.1007/s00775-006-0197-3. Epub 2007 Jan 10. PMID 17216229
- Burghardt RD, Herzenberg JE, Ranade A. Pseudoaneurysm after Ponseti percutaneous Achilles tenotomy: a case report. J Pediatr Orthop. 2008 Apr-May;28(3):366-9. doi: 10.1097/BPO.0b013e3181653b6f. PMID 18362805
- Parada SA, Baird GO, Auffant RA, Tompkins BJ, Caskey PM. Safety of percutaneous tendoachilles tenotomy performed under general anesthesia on infants with idiopathic clubfoot. J Pediatr Orthop. 2009 Dec;29(8):916-9. doi: 10.1097/BPO.0b013e3181c18ab5. PMID 19934709
- Dogan A, Kalender AM, Seramet E, Uslu M, Sebik A. Mini-open technique for the achilles tenotomy in correction of idiopathic clubfoot: a report of 25 cases. J Am Podiatr Med Assoc. 2008 Sep-Oct;98(5):414-7. doi: 10.7547/0980414. PMID 18820046
Identifiers
NCT: NCT07473908 · AUN-ORTHO-US