The Effect of Tibialis Anterior Tendon Transfer on Metatarsus Adductus Deformity in Children with Clubfoot

Introduction:Tibialis anterior tendon transfer (TATT) is a common treatment method used in the dynamic supination of the foot due to sequelae or relapse of pes equinovarus (PEV). In this method, the TAT is transferred from its insertion on the medial cuneiform to the lateral cuneiform. Therefore, TA...

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Main Authors: Osman Nuri Özyalvaç, Akay Kırat, Evren Akpınar, Yaşar Mahsut Dinçel, Barış Özkul, Avni İlhan Bayhan
Format: Article
Language:English
Published: Galenos Yayinevi 2019-01-01
Series:İstanbul Medical Journal
Subjects:
Online Access: http://imj.galenos.com.tr/archives/archive-detail/article-preview/the-effect-of-tibialis-anterior-tendon-transfer-on/21510
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author Osman Nuri Özyalvaç
Akay Kırat
Evren Akpınar
Yaşar Mahsut Dinçel
Barış Özkul
Avni İlhan Bayhan
author_facet Osman Nuri Özyalvaç
Akay Kırat
Evren Akpınar
Yaşar Mahsut Dinçel
Barış Özkul
Avni İlhan Bayhan
author_sort Osman Nuri Özyalvaç
collection DOAJ
description Introduction:Tibialis anterior tendon transfer (TATT) is a common treatment method used in the dynamic supination of the foot due to sequelae or relapse of pes equinovarus (PEV). In this method, the TAT is transferred from its insertion on the medial cuneiform to the lateral cuneiform. Therefore, TATT surgery may have a corrective effect on metatarsus adducus deformity by creating a force vector that pushes the middle of the foot from medial to lateral. However, there is limited literature on the effect of TATT on metatarsus adductus deformity, which is one of the components of clubfoot. The aim of our study was to investigate the effect of TATT on metatarsus adductus deformity.Methods:Sixteen feet of 11 patients who underwent TATT with the diagnosis of PEV between 2007-2015 were included in the study. Pre- and postoperative talus-1.metatarsal angle, talocalcaneal angle and 4. metatars-metaphyseal angle were measured on standing antero-posterior radiographs. The correction rate of metatarsus adductus deformity was statistically analyzed.Results:After a mean follow-up of 26±15 months, the mean talus – 1st metatarsal angle decreased from 18.8±1 degrees to 10.9±6 degrees, the mean talocalcaneal angle from 22.5 degrees ±8.6 to 24.4±9.3 degrees and the mean 4th metatarsalmetaphyseal angle from 38±14 degrees to 27±11 degrees after TATT. While there were statistically significant radiological corrections in talus – 1st metatarsal angle and 4th metatarsalmetaphyseal angle (p<0.05), there was no statistically significant change in the talocalcaneal angle (p=0.51).Conclusion:TATT provides radiological improvement in the metatarsus adductus deformity in children with PEV. The reason for this is that the Tibialis in PEV works as an invertor rather than dorsiflexor/evertor of the ankle. In conclusion, the need for additional surgery for metatarsus adductus deformities in patients undergoing TATT should be reviewed.
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spelling doaj.art-d4a01b3c821540c0a5573092183c536c2023-02-15T16:19:38ZengGalenos Yayineviİstanbul Medical Journal2619-97932148-094X2019-01-01201353810.4274/imj.galenos.2018.1580713049054The Effect of Tibialis Anterior Tendon Transfer on Metatarsus Adductus Deformity in Children with ClubfootOsman Nuri Özyalvaç0Akay Kırat1Evren Akpınar2Yaşar Mahsut Dinçel3Barış Özkul4Avni İlhan Bayhan5 Metin Sabancı Baltalimanı Osteopathic Training and Research Hospital, Clinic of Orthopedics and Traumatology, İstanbul, Turkey Metin Sabancı Baltalimanı Osteopathic Training and Research Hospital, Clinic of Orthopedics and Traumatology, İstanbul, Turkey Metin Sabancı Baltalimanı Osteopathic Training and Research Hospital, Clinic of Orthopedics and Traumatology, İstanbul, Turkey Metin Sabancı Baltalimanı Osteopathic Training and Research Hospital, Clinic of Orthopedics and Traumatology, İstanbul, Turkey Metin Sabancı Baltalimanı Osteopathic Training and Research Hospital, Clinic of Orthopedics and Traumatology, İstanbul, Turkey Metin Sabancı Baltalimanı Osteopathic Training and Research Hospital, Clinic of Orthopedics and Traumatology, İstanbul, Turkey Introduction:Tibialis anterior tendon transfer (TATT) is a common treatment method used in the dynamic supination of the foot due to sequelae or relapse of pes equinovarus (PEV). In this method, the TAT is transferred from its insertion on the medial cuneiform to the lateral cuneiform. Therefore, TATT surgery may have a corrective effect on metatarsus adducus deformity by creating a force vector that pushes the middle of the foot from medial to lateral. However, there is limited literature on the effect of TATT on metatarsus adductus deformity, which is one of the components of clubfoot. The aim of our study was to investigate the effect of TATT on metatarsus adductus deformity.Methods:Sixteen feet of 11 patients who underwent TATT with the diagnosis of PEV between 2007-2015 were included in the study. Pre- and postoperative talus-1.metatarsal angle, talocalcaneal angle and 4. metatars-metaphyseal angle were measured on standing antero-posterior radiographs. The correction rate of metatarsus adductus deformity was statistically analyzed.Results:After a mean follow-up of 26±15 months, the mean talus – 1st metatarsal angle decreased from 18.8±1 degrees to 10.9±6 degrees, the mean talocalcaneal angle from 22.5 degrees ±8.6 to 24.4±9.3 degrees and the mean 4th metatarsalmetaphyseal angle from 38±14 degrees to 27±11 degrees after TATT. While there were statistically significant radiological corrections in talus – 1st metatarsal angle and 4th metatarsalmetaphyseal angle (p<0.05), there was no statistically significant change in the talocalcaneal angle (p=0.51).Conclusion:TATT provides radiological improvement in the metatarsus adductus deformity in children with PEV. The reason for this is that the Tibialis in PEV works as an invertor rather than dorsiflexor/evertor of the ankle. In conclusion, the need for additional surgery for metatarsus adductus deformities in patients undergoing TATT should be reviewed. http://imj.galenos.com.tr/archives/archive-detail/article-preview/the-effect-of-tibialis-anterior-tendon-transfer-on/21510 Clubfootmetatarsus adductuspes equinovarustibialis anterior tendon transfer
spellingShingle Osman Nuri Özyalvaç
Akay Kırat
Evren Akpınar
Yaşar Mahsut Dinçel
Barış Özkul
Avni İlhan Bayhan
The Effect of Tibialis Anterior Tendon Transfer on Metatarsus Adductus Deformity in Children with Clubfoot
İstanbul Medical Journal
Clubfoot
metatarsus adductus
pes equinovarus
tibialis anterior tendon transfer
title The Effect of Tibialis Anterior Tendon Transfer on Metatarsus Adductus Deformity in Children with Clubfoot
title_full The Effect of Tibialis Anterior Tendon Transfer on Metatarsus Adductus Deformity in Children with Clubfoot
title_fullStr The Effect of Tibialis Anterior Tendon Transfer on Metatarsus Adductus Deformity in Children with Clubfoot
title_full_unstemmed The Effect of Tibialis Anterior Tendon Transfer on Metatarsus Adductus Deformity in Children with Clubfoot
title_short The Effect of Tibialis Anterior Tendon Transfer on Metatarsus Adductus Deformity in Children with Clubfoot
title_sort effect of tibialis anterior tendon transfer on metatarsus adductus deformity in children with clubfoot
topic Clubfoot
metatarsus adductus
pes equinovarus
tibialis anterior tendon transfer
url http://imj.galenos.com.tr/archives/archive-detail/article-preview/the-effect-of-tibialis-anterior-tendon-transfer-on/21510
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