SPLATT to Peroneus Brevis vs TATT to Lateral Cuneiform

Not Applicable

• Conditions: Recurrent Congenital Talipes Equinovarus
• Interventions: Procedure: SPLATT

• Registration Number: NCT06300645
• Lead Sponsor: Assiut University

Brief Summary

Congenital talipes equinovarus, is a common congenital foot deformity involving hindfoot equinus and varus, along with mid-/forefoot adduction and cavus. Currently, the Ponseti method is the preferred initial treatment for idiopathic clubfoot1

. Despite the initial phase's remarkable efficacy in correcting clubfeet, there remains a notable recurrence rate after Ponseti treatment2

* Numerous studies demonstrate a very high success rate during early follow-ups, ranging from 92% to 100%3

* Nonetheless, recurrence remains a challenge for orthopedic surgeons. A common trigger for recurrence is the dynamic supination of the foot, which results from excessive activation of the tibialis anterior muscle during ankle dorsiflexion4

Multiple studies indicate that tibialis anterior tendon transfer (TATT) is an effective tool for management of clubfoot recurrence, particularly dynamic supination5

* The widely used technique involves transferring the entire tendon through a drill hole in the lateral cuneiform and anchoring it on the plantar aspect of the foot using a sewing button and felt pad6

* While effective, this procedure raises the risk of pressure sores due to button placement on the sole7

Split anterior tibialis tendon transfer (SPLATT) to peroneus brevis is a well-described treatment strategy of varus foot deformities in patients with neuromuscular disorders8

* The technique has been reported to achieve successful deformity correction while avoiding skin problems associated with external button placement on the sole of the foot in tendon-to-bone transfers8

The present study aims to assess the outcome of utilizing SPLATT to peroneus brevis procedure in the treatment of recurrent CTEV in comparison to the original total TATT to the lateral cuneiform

Detailed Description

Not available

Study Timeline

• Study Start: 2024-01-17
• Status Verified: 2024-03
• Study First Submitted: 2024-03-03
• Study First Submitted QC: 2024-03-03
• Study First Posted: 2024-03-08
• Last Update Submitted: 2024-03-08
• Last Update Posted: 2024-03-12
• Primary Completion: 2025-03-01
• Study Completion: 2026-03-01

Recruitment & Eligibility

• Status: ENROLLING_BY_INVITATION
• Sex: All
• Target Recruitment: 25

Inclusion Criteria

• Recurrent CTEV
• Age between 4 years and 12 years
• Unilateral/bilateral
• Ankle dorsiflexion of at least 10° prior to tendon transfer

Exclusion Criteria

• Non idiopathic CTEV
• Rigid deformity not suitable for acute correction
• Poor skin condition

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
SPLATT	SPLATT	Children with congenital talipes who have been treated with split tibialis anterior tendon transfer to peroneus brevis
TATT	SPLATT	Children with congenital talipes who have been treated with total ribialis anterior tendon transfer to lateral cuneiform

Primary Outcome Measures

Name	Time	Method
Correction of recurrent congenital talipes	1 year	correction is measured by arc of eversion

Trial Locations

Locations (1)

Assiut university hospital; 🇪🇬 Assiut, Egypt