- [Home](https://ortopediaevolutiva.com/en) - [Surgery](https://ortopediaevolutiva.com/en/surgery) - Clubfoot [Back to all surgeries](https://ortopediaevolutiva.com/en/surgery) # Surgery: Clubfoot Percutaneous Achilles tenotomy for clubfoot: procedure, postoperative course and bracing protocol. Dr. Priano, Milan. Ponseti method with possible percutaneous tenotomy [Learn about this condition →](https://ortopediaevolutiva.com/en/conditions/clubfoot) ## Surgical Techniques ### Percutaneous Achilles Tenotomy Small minimally invasive procedure performed at the end of serial casting (Ponseti method) to complete correction of residual equinus. When it is used Frequently necessary during Ponseti treatment of clubfoot, in a large proportion of cases. The decision is clinical, based on residual equinus at the end of serial casting. Recovery Final cast for a few weeks after tenotomy, then abduction brace according to the protocol, with duration tailored to the individual child. ### Extensive Surgical Release More invasive procedure with release of posterior and medial soft tissues to correct resistant deformities or relapses. When it is used Severe relapses, atypical forms resistant to the Ponseti method, syndromic clubfoot. Recovery Postoperative immobilization for some weeks. Long-term night bracing. Dedicated rehabilitation. ### Postoperative Overview Clubfoot requires prolonged follow-up. Adherence to the bracing protocol is the key factor in reducing the risk of relapse. Check-ups continue until the end of growth. The course described below is an indicative pathway, personalised for each child. ## Recovery Pathway (indicative) **Note:** This is an indicative pathway, personalised after surgery. Some elements are relatively stable (goal of the procedure, approximate hospital stay, presence of a cast or brace); others depend on the individual case (weight bearing, range of motion, imaging, sport, hardware removal, follow-up intervals) and on the surgical technique chosen. - Hospital stay Percutaneous tenotomy: a short procedure, usually performed in a day-surgery setting; organisation and anaesthesia are decided case by case. Extensive release: one to two days in hospital. - First weeks After tenotomy: final cast for a few weeks, during which the tendon heals and restores its continuity. The abduction brace (FAB) is then started. - Second month Brace worn for most of the day according to the protocol, with regular visits to verify maintenance of correction and brace fit. - Third month Once correction is stable, transition to night-time and nap-time bracing, with timing decided at follow-up. - Return to sport Night-time bracing continues for several years, often until around age 4-5, according to the prescribed programme. It does not prevent usual daytime play and age-appropriate physical activity. Growth and correction are followed individually. - Follow-up Frequent follow-ups in the first months, then progressively spaced out until the end of growth, with intervals tailored to the individual course. ### Possible Complications Relapses: more frequent with poor brace compliance. Residual stiffness. Muscle weakness. Most relapses can be managed with conservative treatment or tibialis anterior transfer. [For parents Clubfoot: condition information page Causes, diagnosis, conservative options and when surgery is considered.](https://ortopediaevolutiva.com/en/conditions/clubfoot) ### Questions about this surgery? Book a consultation to discuss your child's specific case. [Book a Consultation](https://ortopediaevolutiva.com/en/locations#prenota) ## Complete pathway on the newborn and the first steps This page is part of the newborn and first steps pathway. - [2 Congenital clubfoot A deformity present at birth. The standard pathway is the Ponseti method: manipulations performed by trained staff and serial casts, in most cases a percutaneous Achilles tenotomy, and then the maintenance brace.](https://ortopediaevolutiva.com/en/conditions/clubfoot) [Surgery in clubfoot · you are here](https://ortopediaevolutiva.com/en/surgery/clubfoot) - [Mobilisations after casting, when indicated](https://ortopediaevolutiva.com/en/parents-kids/exercises/parent-mobilizations/clubfoot) - [3 Metatarsus varus in the newborn](https://ortopediaevolutiva.com/en/conditions/metatarsus-varus) - [1 Newborn orthopaedic screening](https://ortopediaevolutiva.com/en/conditions/newborn-screening) ### Related Articles - [Related Condition](https://ortopediaevolutiva.com/en/conditions/clubfoot) - [Document Checklist](https://ortopediaevolutiva.com/en/visit-guide/document-checklist) - [Locations & Booking](https://ortopediaevolutiva.com/en/locations) ### Need clarification? Book a specialist visit at the Gaetano Pini Institute or CTO Milan. [View Locations & Book](https://ortopediaevolutiva.com/en/locations) --- Canonical: https://ortopediaevolutiva.com/en/surgery/clubfoot Le informazioni cliniche sono divulgative e non sostituiscono una valutazione medica diretta.