Does Percutaneous Achilles Tenotomy Yield Comparable Short-Term Outcomes to Combined Open Achilles Tenotomy with Posterior Capsulotomy in Pediatric Patients with Clubfoot?

Autor: Marine Coste BA, Mikhail Tretiakov MD, Neil V. Shah MD, MS, Daniel M. Zuchelli MD, Joanne C. Dekis MD, Scott C. Pascal MD, Leslie N. Davidson MD, Claude B. Scott MD, PhD, Khalid Hesham MD, Jaime A. Uribe MD
Jazyk: angličtina
Rok vydání: 2019
Předmět:
Zdroj: Foot & Ankle Orthopaedics, Vol 4 (2019)
Druh dokumentu: article
ISSN: 2473-0114
24730114
DOI: 10.1177/2473011419S00152
Popis: Category: Hindfoot, Midfoot/Forefoot, Congenital Introduction/Purpose: As the most common musculoskeletal congenital anomaly, clubfoot (congenital talipes equinovarus) represents a commonly-encountered entity for pediatric orthopaedic and foot/ankle surgeons. As we have observed a shift towards more conservative, cost-conscious approaches to management, this study sought to compare short-term (30-day) perioperative and postoperative outcomes (complications and reoperations) in clubfoot patients who underwent either percutaneous Achilles tenotomy (PT) or combined open Achilles tenotomy with posterior capsulotomy (COTC). Methods: The National Surgical Quality Improvement Program (NSQIP) Pediatric Database was queried for all congenital clubfoot patients. Among those, patients who underwent percutaneous Achilles tenotomy (PT; CPT: 27606) or open Achilles tenotomy with posterior capsulotomy (COTC; CPT: 28262) were stratified into two cohorts. Cohorts were 1:1 propensity score-matched for gender, race, congenital clubfoot diagnosis, and ASA score. Demographics, peri- and 30-day postoperative data were collected for each group and compared using appropriate parametric tests. A p-value of 0.05 or lower indicated statistical significance. A binary stepwise multivariate regression model was used to assess the effects of age, gender, race, ASA score, congenital clubfoot, and surgery type on total complication and reoperation rates. Results: 690 patients were included (PT, n=345; COTC, n=345). PT patients were younger than COTC patients (1.58 vs. 4.26 years; p
Databáze: Directory of Open Access Journals
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