Letter To Editor
Volume 2 | Issue 2 | JOCR April – June 2012 | Page 29 |Patwardhan S, Shyam AK, Sancheti P.
Percutaneous Needle Tenotomy for Tendo-achillis Release in Clubfoot- Authors’ Reply
Sandeep Patwardhan, Ashok Shyam, Parag Sancheti
Sancheti Institute for Orthopaedics and Rehabiltiation Pune, India
Address of Correspondence
Dr Ashok Shyam Sancheti Institute for Orthopaedics and Rehabiltiation Pune, India
We appreciate the interest of Patnaik S  in our paper published in Journal of Orthoapedic Case Reports  and thank him for sharing his experience with the technique. We shall answers the queries raised sequentially. We are routinely using 16 or 18 gauge needle depending on the size of the child and in very young child infant a 18 gauge needle is enough. The trick is to tense the tendon by dorsiflexion and then cutting with the tip of the needle [you can feel the grating. This does not require a strong force if layer by layer cutting using the tip of the needle is done. Do not try to cut the entire tendon in one go. As one does more cases, an idea of
force needed and needle that is best suited is developed. We have done this procedure as a part of ponseti technique, thus the indications of age are extension of ponseti and the procedure can be done safely till 6-8 months of age. We are routinely using Pirani scoring  for assessment of our cases. The follow up protocol is same as ponseti protocol and as mentioned in the article corrective cast is given for 3 weeks. We again appreciate the interest in our technique and sincerely hope it benefits more surgeons and patients.
1.Patnaik S. Percutaneous Needle Tenotomy for Tendo-achillis Release in Clubfoot- A Response. J Orthopaedic Case Reports 2012 April June;2(2):
2.Patwardhan S, Shyam AK, Sancheti P. Percutaneous Needle Tenotomy for Tendo-achillis Release in cases of Clubfoot – Technical Note. J Ortho Case Reports 2012;2(1):35-36.
3.Pirani S, Outerbridge HK, Sawatzky B et al (1999) A reliable method of clinically evaluating a virgin clubfoot evaluation. In: Proceedings of the 21st SICOT World Congress, Sydney, Australia.
How to Cite This Article:
Patwardhan S, Shyam AK, Sancheti P. Percutaneous Needle Tenotomy for Tendo-achillis Release in cases of Clubfoot – Authors reply.J Ortho Case Reports 2012;April-June;2(2):29.Available from: https://www.jocr.co.in/wp/wp-content/uploads/2012/06/FINAL-Letter.pdf