Correction of relapsed or neglected clubfoot using a simple Ilizarov frame

Barbary, Hassan El; Abdel-Ghani, Hisham; Hegazy, Mohamed

doi:10.1007/s00264-004-0540-7

Cited by 47 publications

(38 citation statements)

References 11 publications

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“…In our study, there was a fixed period of transfixation of midfoot joints in both groups with different previous treatment (Ponseti method and posteromedial release), and we did not find any differences in the postoperative clinical scores or foot angle values even when the patients had scar contracture owing to previous posteromedial release. El Barbary et al [5] also reported that eight of 41 feet with relapsed clubfeet had no previous surgery and there was no difference in correction or recurrence between the different treatment groups. Our patients with soft tissue scars from previous posteromedial release wore the frame for a longer time (mean, 43 versus 34 days) compared with patients who had the Ponseti method.…”

Section: Discussionmentioning

confidence: 95%

“…The talus is the fulcrum around which the entire foot couples kinematically [19]. Previous studies reported recurrence of foot deformity after removal of the Ilizarov frame even though the Ilizarov frame was maintained for several weeks after full correction of initial foot deformity and a below-knee cast or orthosis also was applied [1,5,8,21,25]. Prem et al [21] reported that 18 of 19 feet with relapsed congenital clubfoot were plantigrade after correction with the Ilizarov frame, but their patients wore the frame for 16 weeks.…”

Section: Discussionmentioning

confidence: 99%

“…Prem et al [21] reported that 18 of 19 feet with relapsed congenital clubfoot were plantigrade after correction with the Ilizarov frame, but their patients wore the frame for 16 weeks. El Barbary et al [5] reported that 41 idiopathic clubfeet treated by soft tissue distraction had painless plantigrade feet at the last followup. Their patients wore the frame an additional 4 to 6 weeks after correction.…”

Section: Discussionmentioning

confidence: 99%

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Does Short-term Application of an Ilizarov Frame with Transfixion Pins Correct Relapsed Clubfoot in Children?

Refai

Song

2012

Clinical Orthopaedics &Amp; Related Research

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Background Treatment of relapsed clubfoot after soft tissue release in children is difficult because of the high recurrence rate and related complications. Even though the Ilizarov method is used for soft tissue distraction, there is a high incidence of recurrence after removal of the Ilizarov frame owing to previous contracture of soft tissue and a skin scar. Questions/Purposes We asked (1) whether transfixation of midfoot joints by temporary K wires during the consolidation stage after short-term application of an Ilizarov frame would maintain correction of the relapsed clubfoot clinicoradiologically and (2) whether this method would reduce the rate of recurrence and related complications in patients with a skin scar from previous surgery.

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Section: Discussionmentioning

confidence: 95%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Does Short-term Application of an Ilizarov Frame with Transfixion Pins Correct Relapsed Clubfoot in Children?

Refai

Song

2012

Clinical Orthopaedics &Amp; Related Research

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“…Relapse of the deformity, defined as the child walking on the side of the foot, or when shoe fitting is a problem [11], was noted. Functional results were evaluated according to the Laaveg and Ponseti classification [26].…”

Section: Methodsmentioning

confidence: 99%

Can Selective Soft Tissue Release and Cuboid Osteotomy Correct Neglected Clubfoot?

Faldini¹,

Traina²,

Martino³

et al. 2013

Clinical Orthopaedics &Amp; Related Research

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Background Neglected clubfoot in older children is characterized by a stiff, nonreducible deformity with relative elongation of the lateral column of the foot with respect to the medial column. Surgical correction often has involved a double osteotomy with elongation of the medial column and shortening of the lateral column, or the use of an external fixator to achieve more gradual correction. Both approaches have shortcomings. Questions/purposes We therefore (1) used objective physical examination measurements and a functional assessment to evaluate the effectiveness of cuboid osteotomy combined with a selective soft tissue release to achieve correction of neglected clubfoot in older children, (2) determined the rate of complications, and (3) ascertained whether the initial correction achieved was maintained. Methods We reviewed 31 patients (56 feet) older than 5 years with severe, neglected nonreducible clubfoot deformity who underwent the index procedure. Minimum followup was 2 years (average, 6 years; range, 2-9 years). Postoperatively, the Laaveg and Ponseti classification and Dimeglio score were used to grade correction. Complication rates were tallied. Results According to the Laaveg and Ponseti classification, 24 feet showed excellent correction, 20 good, nine fair, and three poor at 1-year followup. These results were maintained up to the latest followup. Patients showed significant improvement of Dimeglio score after surgery (p \ 0.0001). Two patients had postoperative skin-related complications that healed without additional surgery.

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“…Major complications associated with wound healing are observed with both types of incision [15]. In order to avoid wound complications, a number procedures such as staged surgery [16], casting with suboptimal correction after surgery followed by serial manipulation [17], expecting secondary healing following partial wound closure [18], or multi-step correction with circular external Wxator may be applied [19][20][21]. In single-step surgery, the risk of wound healing problems is increased on the line of the incision.…”

Section: Discussionmentioning

confidence: 99%

Technical details of using sural flap in pes equinovarus surgery: a preliminary report on the technique

Isik

Ceylan

Güner

et al. 2011

Eur J Orthop Surg Traumatol

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Pes equinovarus is a congenital disease that can be successfully treated with serial casting and percutaneous achillotomy at the newborn stage in most of the cases. Complex surgical interventions are required for patients presenting at advanced age for correction of this deformity. The main problem encountered in the treatment for neglected pes equinovarus cases is repairing the posteromedial skin defect of the ankle due to surgical correction of this deformity. The sural Xap is frequently used in the repair of a number of skin defects on the ankles, although reports on the use of this Xap in pes equinovarus surgery are scarce. In this article, the technical details of sural Xap application in cases with neglected pes equinovarus and the preliminary results of three extremities treated with this method have been presented.

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Correction of relapsed or neglected clubfoot using a simple Ilizarov frame

Cited by 47 publications

References 11 publications

Does Short-term Application of an Ilizarov Frame with Transfixion Pins Correct Relapsed Clubfoot in Children?

Does Short-term Application of an Ilizarov Frame with Transfixion Pins Correct Relapsed Clubfoot in Children?

Can Selective Soft Tissue Release and Cuboid Osteotomy Correct Neglected Clubfoot?

Technical details of using sural flap in pes equinovarus surgery: a preliminary report on the technique

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