Effects of Intramuscular Tenotomy on Tibialis Posterior Lengthening
Author Information
Author(s): Altuntas Altay O., Dagge Benjamin, Chin Terence Y. P., Palamara Joseph E. A., Eizenberg Norman, Wolfe Rory, Graham H. Kerr
Primary Institution: Orthopaedic Department, The Royal Children’s Hospital
Hypothesis
The site of intramuscular tenotomy (IMT) within the muscle–tendon-unit (MTU) of the tibialis posterior (TP) would affect the lengthening characteristics.
Conclusion
The site of the tenotomy affects the amount of lengthening achieved, which may contribute to variability in clinical outcomes.
Supporting Evidence
- Low IMT resulted in 48% more lengthening than high IMT.
- Mean load at failure was significantly lower for low IMT compared to high IMT.
- The study suggests that the site of the tenotomy can be adjusted to achieve desired surgical outcomes.
Takeaway
Changing where the surgery is done on a muscle can make it stretch more or less, which helps doctors fix foot problems in kids.
Methodology
A randomized trial on paired cadaver tibialis posterior muscle–tendon-units (TP-MTUs) was conducted, comparing high and low intramuscular tenotomy using tensile testing.
Potential Biases
The study's findings may not be directly applicable to the clinical setting due to differences between cadaveric and living tissues.
Limitations
The study used cadaveric tissue, which may not fully represent the clinical situation in living patients.
Participant Demographics
Ten formalin-preserved human cadavers, mean age 82 years, with equal male and female representation.
Statistical Information
P-Value
0.004
Confidence Interval
95% CI 7.9–23.5 mm for low IMT; 95% CI 4.6–16.6 mm for high IMT
Statistical Significance
p=0.004
Digital Object Identifier (DOI)
Want to read the original?
Access the complete publication on the publisher's website