Percutaneous Achilles Tendon Tenotomy vs Tendo-Achilles Lengthening (TAL) in Neglected Clubfoot Children.

Functional Outcomes of Percutaneous Achilles Tendon Tenotomy vs Tendo-Achilles Lengthening (TAL) in Neglected Clubfoot Children Age 2-5 Years.

Achilles tendon tenotomy is the established worldwide gold standard for correcting idiopathic clubfoot. However, in neglected cases, surgical interventions such as percutaneous Achilles tendon tenotomy (PAT) and open tendo-Achilles lengthening (TAL) are common techniques for correcting this deformity. This study aimed at determining the functional outcomes of Percutaneous Achilles Tendon Tenotomy (PAT) vs tendo-Achilles Lengthening (TAL) in the neglected clubfoot children of age 2-5 years.

Study Overview

• Status: Recruiting
• Conditions: Clubfoot
• Intervention / Treatment: Procedure: Tenotomy of Achilles Tendon; Procedure: Tendo-Achilles Lengthening

Detailed Description

Despite the increasing use of percutaneous techniques, there is a lack of literature directly comparing the functional outcomes of these two procedures, PAT and TAL. Addressing this knowledge gap is essential to guide pediatric orthopedic surgeons in selecting the most appropriate intervention for the treatment of equinus deformity in neglected clubfoot patients, optimizing functional recovery, minimizing complications, and ultimately improving the quality of care for children with neglected clubfoot.

• Study Type: Observational
• Enrollment (Estimated): 44

Contacts and Locations

• Study Contact: Name: Pervez Ali, FCPS; Phone Number: +923333001737; Email: pervez73@hotmail.com
• Study Contact Backup: Name: Sidratul Zaitoon; Phone Number: +923150012163; Email: sidra9503@gmail.com

Study Locations

• Pakistan
  • Sindh
    • Karachi, Sindh, Pakistan, 75510
      • Recruiting
      • Jinnah Postgraduate Medical Centre
      • Contact: Pervez Ali, FCPS; Phone Number: +923333001737; Email: pervez73@hotmail.com
      • Contact: Sidratul Zaitoon; Phone Number: +923150012163; Email: sidra9503@gmail.com
      • Principal Investigator: Sidratul Zaitoon
      • Sub-Investigator: Pervez Ali

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Child
• Accepts Healthy Volunteers: No

• Sampling Method: Non-Probability Sample

Study Population

Newly diagnosed patients of clubfoot between 2 and 5 years of age having Pirani score 3-6 within the study period will be recruited.

Description

Inclusion Criteria:

• Any gender
• Aged 2-5 years
• diagnosed with clubfoot
• Pirani score 3-6

Exclusion Criteria:

• Patients with other neuromuscular, chromosomal abnormalities
• myelomeningocele
• Dystrophic dysplasia
• Moebius syndrome
• Amniotic band syndrome
• Metatarsus adductus
• Syndactyly
• Polydactyly
• Previously underwent Achilles tendon tenotomy or tendo-Achilles lengthening

Study Plan

How is the study designed?

Number of groups / cohorts

2

Cohorts and Interventions

Group / Cohort	Intervention / Treatment
Percutaneous Achilles Tendon Tenotomy-Group; Patients will be started on serial casting and manipulation according to ponseti method. After successful correction of cavus, varus, and adductus, patients will be treated using the tenotomy of Achilles tendon technique.	Procedure: Tenotomy of Achilles Tendon; Patients will be started on serial casting and manipulation according to ponseti method. After successful correction of cavus, varus, and adductus, patients will be treated using the tenotomy of Achilles tendon technique.
Tendo-Achilles Lengthening-Group; Patients will be started on serial casting and manipulation according to ponseti method. After successful correction of cavus, varus, and adductus, patients will be treated using the tendo-Achilles Lengthening technique.	Procedure: Tendo-Achilles Lengthening; Patients will be started on serial casting and manipulation according to ponseti method. After successful correction of cavus, varus, and adductus, patients will be treated using the Tendo-Achilles Lengthening technique.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Improvement in ankle dorsiflexion	Frequency of patients with improvement in ankle dorsiflexion will be noted.	6 months

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Bleeding	Frequencies of bleeding as none, mild moderate, and severe will be noted.	1 hour
Infection	Frequency of patients who had an infected wound will be noted.	6 months
Incomplete tenotomy	Frequency of patients who will have incomplete release or residual deformity assessed after 6 months.	6 months

Collaborators and Investigators

• Sponsor: Muhammad Aamir Latif
• Investigators: Study Director: Pervez Ali, FCPS, Jinnah Postgraduate Medical Centre, Karachi, Pakistan; Principal Investigator: Sidratul Zaitoon, Jinnah Postgraduate Medical Centre, Karachi, Pakistan

Study record dates

Study Major Dates

• Study Start (Actual): August 15, 2025
• Primary Completion (Estimated): April 30, 2026
• Study Completion (Estimated): April 30, 2026

Study Registration Dates

• First Submitted: April 24, 2026
• First Submitted That Met QC Criteria: April 24, 2026
• First Posted (Actual): May 1, 2026

Study Record Updates

• Last Update Posted (Actual): May 1, 2026
• Last Update Submitted That Met QC Criteria: April 24, 2026
• Last Verified: April 1, 2026

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Talipes; Musculoskeletal Diseases; Musculoskeletal Abnormalities; Congenital Abnormalities; Lower Extremity Deformities, Congenital; Limb Deformities, Congenital; Foot Deformities; Foot Deformities, Acquired; Foot Deformities, Congenital; Congenital, Hereditary, and Neonatal Diseases and Abnormalities; Clubfoot
• Other Study ID Numbers: Dr-Pervez-Ali-Karachi

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO
• IPD Plan Description: Data can be shared on a reasonable request.

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No