FREQUENCY OF PERCUTANEOUS ACHILLES TENDON TENOTOMY IN CLUB FOOT CHILDREN TREATED BY PONSETTI METHOD IN ORTHOPAEDIC A WARD OF AYUB TEACHING HOSPITAL ABBOTTABAD

Background: The Ponseti technique of congenital clubfoot therapy includes interventional Achilles tenotomy. The goal of this research was to evaluate the frequency and effectiveness of interventional Achilles tenotomy in the Ponseti method's conservative management of congenital clubfoot. Methods: Between August 2023 and June 2024, a randomized controlled trial was conducted of all congenital club foot deformity patients between the ages of 0 and 2 years who visited our clubfoot clinic was conducted. Upon presentation, each clubfoot had a clinical evaluation, a Pirani grading system rating, and a Ponseti procedure cure.  The distribution and associations of percutaneous Achilles tenotomies were statistically examined using IBM SPSS version 26. Results: Ninety-seven individuals in all, 147 of them had a club foot, were examined. Midfoot contracture score (MFCS), hindfoot contracture score (HFCS), and total Pirani score (TPS) medians were 4.5, 2.5, and 2.5, respectively, upon presentation. 66.4% (97) feet belonging to 63 individuals had percutaneous Achilles tenotomies done. With an initial total Perini score of 3.0 or higher, 85 out of 108 feet needed percutaneous Achilles tenotomy to correct the problem (p-0.001). Conclusion: A tenotomy rate of 66.4% was seen while treating bilateral clubfoot by using the Ponseti procedure. Percutaneous Achilles tenotomy was required when the patient had high Pirani ani scores and was becoming older at the time of presentation.