Ruptured pseudoanuerysm of the posterial tibial artery after percutaneous Achilles tenotomy

Abstract

Congenital talipes equinovarus (CTEV), or clubfoot, is the the most common encountered musculoskeletal defect encountered at birth. Most cases present as an isolated deformity, with up to half of them presenting with bilateral deformity. CTEV have also been reported to present as part of syndromic phenomena. Dr Igancio Ponseti proposed a serial casting programme to correct the foot’s cavus, forefoot adduction, varus and equinus. Up to 90% of infants will require a tendo-achilles (TA) tenotomy for the persisting equinus deformity. TA tenotomy is deemed a relatively safe procedure, with the most authors citing bleeding as the most common complication. The Achilles tendon finds itself surrounded by rich network of blood vessels and nerves. We present a case of a ruptured pseudoaneurysm from the posterior tibial artery after percutaneous TA tenotomy was performed. This is a very rare complication and to our knowledge, only one other posterior tibial artery pseudoaneurysm has been reported.