Achilles Lengthening/Posterior Tibial Tenotomy with Immediate Weightbearing for Patients with Significant Comorbidities

Abstract

Background: Fixed equinovarus deformities can be challenging to treat especially in medically debilitated patients. The purpose of this study was to evaluate Achilles lengthening with posterior tibial tenotomy and immediate weightbearing in this difficult group of patients. Materials and Methods: Thirteen extremities in 10 patients underwent Achilles lengthening and posterior tibial tenotomy for fixed equinovarus deformities with significant medical comorbidities. Pre- and postoperative ambulatory status and deformities were noted. Results: Average age at the time of surgery was 65 with an average duration of deformity 6.3 years. The average equinus corrected from 26 degrees to 1.2 degrees and the average varus deformity improved from —8.5 degrees to 2.7 degrees. All patients except one who was wheelchair-bound had a significant improvement in ambulatory status. Conclusion: Achilles lengthening with posterior tibial tenotomy allowed for immediate postoperative weightbearing with improvement in deformity and ambulatory status in this complicated patient group.