Ankle tenotomy is a surgical procedure to lengthen the Achilles tendon enabling the ankle to flex upward and allowing the heel to be placed flat on the floor. It is indicated in patients that have an abnormally developed Achilles tendon or one that has become shortened and difficult to stretch. The surgery is done to restore the normal range of motion of the ankle.
It is commonly indicated in the treatment of the below conditions when conservative measures such as physical therapy and splinting have failed:
Clubfoot: A developmental disorder where one is born with one or more abnormally short ankle muscles which turn the feet inward. Ankle tenotomy is usually performed after the Ponseti method to treat clubfoot.
Contractures: Muscles become stiff after a period of immobilisation
Ankle tenotomy is performed under local anaesthesia. A knife is inserted into the skin at the region of the tendon and cuts are made. As the cut edges draw apart, the tendon lengthens and heals in this position. For more severe cases, your child’s doctor may expose the tendon through an incision under general anaesthesia and cut the tendon, which is then joined by sutures to form a lengthened tendon. Casts are then applied with the tendon in the correct anatomic (stretched) position. After two to three weeks, your child’s doctor will remove the cast and order physical therapy to improve ankle strength and keep the tendon stretched.
As with all surgical procedures, ankle tenotomy may be associated with certain complications such as nerve and blood vessel damage, infection, over-lengthening of the tendon or shortening of the tendon as your child grows which may require a second surgery.