Resistant clubfoot deformities managed by Ilizarov distraction histogenesis

Makhdoom, Asadullah; Qureshi, Pir Abdul Latif; Jokhio, Muhammad Faraz; Siddiqui, Khaleeque Ahmed

doi:10.4103/0019-5413.96385

Cited by 16 publications

(18 citation statements)

References 18 publications

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“…These ranged from just using soft-tissue distraction alone to achieve joint realignment (closed 'bloodless' technique) [2,3,[5][6][7][8][9][10][11][20][21][22]24,26] to the use of an adjunctive soft tissue release, foot distraction osteotomies, or both [2,[12][13][14][15][16][17][18][19]23,[27][28][29][30][31][32][33][34][35][36].…”

Section: Discussionmentioning

confidence: 99%

Ilizarov techniques with limited adjunctive surgical procedures for the treatment of preadolescent recurrent or neglected clubfeet

Khanfour

2013

Journal of Pediatric Orthopaedics B

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When choosing the Ilizarov technique for the treatment of recurrent or neglected clubfeet deformity, there was a consensus on the treatment of 3-8-year-old children by the soft-tissue distraction 'bloodless method' either alone or with an adjunctive-limited soft tissue release; whereas, in older children, adjunctive osteotomies were required. Major foot osteotomies such as V, U, Y, or supramalleolar types were established for patients after puberty when the foot bones become fully ossified. So, children falling in the age group between 8 and 13 years (preadolescents) represents a transitional growing stage that has its identity that makes carrying out major foot osteotomies unsuitable. Twenty-five feet in 21 patients with a mean age at the time of operation of 10.9 years (range, 9-13 years) with recurrent or neglected clubfeet deformity who presented to the orthopedic department at Alexandria (Egypt) between February 2004 and December 2008 were treated with the Ilizarov technique combined with adjunctive limited bony and/or soft-tissue procedures as will be discussed. After a mean follow-up period of 3.6 years (range, 2-7 years), 21 children showed good results, four children showed fair results, and no poor results were recorded. No major complications were reported. The Ilizarov technique with limited bony and/or soft-tissue procedures can be considered as a suitable, convenient, efficient, and successful salvage procedure for preadolescent recurrent or neglected clubfeet.

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Section: Discussionmentioning

confidence: 99%

Ilizarov techniques with limited adjunctive surgical procedures for the treatment of preadolescent recurrent or neglected clubfeet

Khanfour

2013

Journal of Pediatric Orthopaedics B

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“…Ilizarov technique is an effective treatment for talipes equinovarus, especially for those with various complex foot deformities. 2,3 But, the sole use of Ilizarov technique may be associated with complications. In addition, surgical methods alone often result in poor correction effect and a high relapse rate from 20% to 50% which requires further operations.…”

Section: Introductionmentioning

confidence: 99%

Ilizarov technique and limited surgical methods for correction of post‐traumatic talipes equinovarus in children

Wang

Chang

et al. 2017

ANZ Journal of Surgery

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Background: The objective of this study was to evaluate the efficacy and safety of using Ilizarov invasive distraction technique combined with limited surgical operations in the treatment of post-traumatic talipes equinovarus in children. Methods: Eighteen cases of post-traumatic deformed feet in 15 patients who received the treatment of Ilizarov frame application, limited soft-tissue release or osteotomy were selected in this study. After removal of the frame, an ankle–foot orthosis was used continuously for another 6–12 months. Pre- and post-operatively, the International Clubfoot Study Group (ICFSG) score was employed to evaluate the gait and range of motion of the ankle joint. Radiographical assessment was also conducted. Results: Patients were followed up for 22 (17–32) months. Ilizarov frame was applied for a mean duration of 5.5 (4–9) months. When it was removed, the gait was improved significantly in all the patients. The correction time was 6–8 weeks for patients who underwent soft-tissue release and 8–12 weeks for those with bone osteotomy. At the last follow-up assessment, the differences between pre- and post-operative plantar-flexion angle, dorsiflexion, motion of ankle joint and talocalcaneal angle were significant (all P < 0.05). The observed complications included wire-hole infection in one foot, toe contracture in one, residual deformity in three, recurrence of deformity in two and spastic ischaemia in one foot. Conclusion: Our findings suggest that Ilizarov technique combined with limited surgical operation can be considered as an efficient and successful method for correction of post-traumatic talipes equinovarus in children.

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“…A plaster cast immobilization is used for six weeks, followed by orthosis for three to six months 15, 18…”

Section: Introductionmentioning

confidence: 99%

“…The time of external fixator use, considering these series, ranged from two to 14 months, with means ranging between five and nine months 3, 4, 8, 15, 16, 18. Refai et al 11 presented a series of 19 cases of legs treated with Ilizarov fixator, used for five weeks, and subsequent use of cast immobilization, including midfoot wires during the consolidation phase.…”

Section: Introductionmentioning

confidence: 99%

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Surgical treatment of neglected clubfoot using external fixator

Fernandes

Mendes

Amorim

et al. 2016

Revista Brasileira de Ortopedia (English Edition)

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The definition of neglected clubfoot (NC) includes a variable range of complex deformities of the foot that are refractory to conventional treatments or are treated inappropriately. Several etiologies may be related to this. The Ilizarov method has become established as a tool for treating these deformities. It minimizes soft-tissue damage through gradual correction of the deformity, with a high success rate in relation to achieving a plantigrade foot, with low incidence of recurrence. The indications for treatment include severe rigid deformities (Dimeglio III and IV), or adverse skin conditions. Careful clinical and radiological examination is fundamental for proper planning and installation of the external fixator. The techniques used include selection of external fixation assemblies, which can be closed when there is a connection between the leg, hindfoot and forefoot. This closed assembly may or may not be constricted, according to whether hinges are provided or whether use of the natural anatomical hinges during correction of the deformity is envisaged. An open assembly makes it possible to add flexibility to the foot through histogenesis, while allowing closed corrections of greater precision later on. Hexapod fixators are an innovation with high potential for accuracy in correcting deformities. Procedures associated with external fixation include soft-tissue release and bone procedures. These procedures enable corrections that are more anatomical, for different degrees of severity and stiffness of deformity. It can be concluded from analyzing this case series that treatment of neglected clubfoot using an external fixator has a high rate of good and excellent results, with low frequency of complications.

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Resistant clubfoot deformities managed by Ilizarov distraction histogenesis

Cited by 16 publications

References 18 publications

Ilizarov techniques with limited adjunctive surgical procedures for the treatment of preadolescent recurrent or neglected clubfeet

Ilizarov techniques with limited adjunctive surgical procedures for the treatment of preadolescent recurrent or neglected clubfeet

Ilizarov technique and limited surgical methods for correction of post‐traumatic talipes equinovarus in children

Surgical treatment of neglected clubfoot using external fixator

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