Radiographic Impact on the Clinical Decision Making of Achilles Tenotomy in Clubfoot: In Search of an Objective Cut-Off Value
Background: We tried to determine whether the indication of Achilles tenotomy (AT) in clubfoot patients based on clinical evaluation could be confirmed radiographically, and to find an objective radiographic cut-off value for its indication. Methods: Eighty-six clubfeet from 60 patients, (26 bilater...
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| Format: | Article |
| Language: | English |
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MDPI AG
2024-01-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/13/3/714 |
| _version_ | 1797318609396039680 |
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| author | Mehmet Burak Yalçın Ahmet Dogan Onat Uzumcugil Gazi Zorer |
| author_facet | Mehmet Burak Yalçın Ahmet Dogan Onat Uzumcugil Gazi Zorer |
| author_sort | Mehmet Burak Yalçın |
| collection | DOAJ |
| description | Background: We tried to determine whether the indication of Achilles tenotomy (AT) in clubfoot patients based on clinical evaluation could be confirmed radiographically, and to find an objective radiographic cut-off value for its indication. Methods: Eighty-six clubfeet from 60 patients, (26 bilateral and 34 unilateral) were included. A standard Ponseti treatment regimen was applied. Group 1 comprised patients who underwent AT immediately after serial plaster casting (26 feet). Group 2 comprised patients who underwent AT during the follow-up period (48 feet). Group 3 comprised patients who were assumed to have a corrected foot and did not undergo AT (12 feet). Group 4 comprised the healthy sides of the unilateral cases (34 feet). Results: Both Group 1 and Group 2 showed significant improvement after tenotomy (<i>p</i> = 0.002). In order to differentiate between the normal and AT groups according to the pre-tenotomy angle, we obtained an optimal cut-off value of >85° according to the Youden index, a sensitivity of 96%, a specificity of 91.2%, a positive predictive value of 95.9%, a negative predictive value of 91.2%, and an accuracy rate of 94.4% (AUC: 0.983; <i>p</i> < 0.001). Conclusions: Feet with a lateral tibio-calcaneal angle > 85° can be considered pathologic and accepted as candidates for AT. |
| first_indexed | 2024-03-08T03:54:49Z |
| format | Article |
| id | doaj.art-913c4f7e9492407fbf4366ad688b0e81 |
| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-08T03:54:49Z |
| publishDate | 2024-01-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Clinical Medicine |
| spelling | doaj.art-913c4f7e9492407fbf4366ad688b0e812024-02-09T15:15:41ZengMDPI AGJournal of Clinical Medicine2077-03832024-01-0113371410.3390/jcm13030714Radiographic Impact on the Clinical Decision Making of Achilles Tenotomy in Clubfoot: In Search of an Objective Cut-Off ValueMehmet Burak Yalçın0Ahmet Dogan1Onat Uzumcugil2Gazi Zorer3Department of Orthopedics and Traumatology, Bahcelievler Memorial Hospital, Istanbul 34180, TurkeyIndependent Researcher, Istanbul 34158, TurkeyIndependent Researcher, Istanbul 34158, TurkeyIndependent Researcher, Istanbul 34158, TurkeyBackground: We tried to determine whether the indication of Achilles tenotomy (AT) in clubfoot patients based on clinical evaluation could be confirmed radiographically, and to find an objective radiographic cut-off value for its indication. Methods: Eighty-six clubfeet from 60 patients, (26 bilateral and 34 unilateral) were included. A standard Ponseti treatment regimen was applied. Group 1 comprised patients who underwent AT immediately after serial plaster casting (26 feet). Group 2 comprised patients who underwent AT during the follow-up period (48 feet). Group 3 comprised patients who were assumed to have a corrected foot and did not undergo AT (12 feet). Group 4 comprised the healthy sides of the unilateral cases (34 feet). Results: Both Group 1 and Group 2 showed significant improvement after tenotomy (<i>p</i> = 0.002). In order to differentiate between the normal and AT groups according to the pre-tenotomy angle, we obtained an optimal cut-off value of >85° according to the Youden index, a sensitivity of 96%, a specificity of 91.2%, a positive predictive value of 95.9%, a negative predictive value of 91.2%, and an accuracy rate of 94.4% (AUC: 0.983; <i>p</i> < 0.001). Conclusions: Feet with a lateral tibio-calcaneal angle > 85° can be considered pathologic and accepted as candidates for AT.https://www.mdpi.com/2077-0383/13/3/714Achilles tenotomyclubfootPonsetiradiology |
| spellingShingle | Mehmet Burak Yalçın Ahmet Dogan Onat Uzumcugil Gazi Zorer Radiographic Impact on the Clinical Decision Making of Achilles Tenotomy in Clubfoot: In Search of an Objective Cut-Off Value Journal of Clinical Medicine Achilles tenotomy clubfoot Ponseti radiology |
| title | Radiographic Impact on the Clinical Decision Making of Achilles Tenotomy in Clubfoot: In Search of an Objective Cut-Off Value |
| title_full | Radiographic Impact on the Clinical Decision Making of Achilles Tenotomy in Clubfoot: In Search of an Objective Cut-Off Value |
| title_fullStr | Radiographic Impact on the Clinical Decision Making of Achilles Tenotomy in Clubfoot: In Search of an Objective Cut-Off Value |
| title_full_unstemmed | Radiographic Impact on the Clinical Decision Making of Achilles Tenotomy in Clubfoot: In Search of an Objective Cut-Off Value |
| title_short | Radiographic Impact on the Clinical Decision Making of Achilles Tenotomy in Clubfoot: In Search of an Objective Cut-Off Value |
| title_sort | radiographic impact on the clinical decision making of achilles tenotomy in clubfoot in search of an objective cut off value |
| topic | Achilles tenotomy clubfoot Ponseti radiology |
| url | https://www.mdpi.com/2077-0383/13/3/714 |
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