The correction of the relapsed club foot by closed distraction

Abstract

Correction of a relapsed clubfoot deformity by distraction with an external fixator is a recognized alternative to open surgery. Most published series report a good outcome but none are prospective observational studies using the scoring system of the International Clubfoot Study Group (ICFSG). We present a series of 9 relapsed club feet treated with closed gradual distraction using this scoring method.

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

“…4); results were considered fair if there was a presence of a mild deformity that did not interfere with the use of a normal shoe, the parents were still satisfied, there was presence of mild pain that did not interfere with daily activities, and the patient could still walk for long distances; and results were considered poor if there was recurrence of deformity, marked pain, significant limitation of activity, and the parents were dissatisfied. the talus have been reported in many literature reports using the Ilizarov bloodless technique [5,7,10,22]. It hardly occurs in cases where distraction foot osteotomies are used as here, correction will take place through the osteotomy site.…”

“…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].…”

“…Proponents to the bloodless Ilizarov distraction technique attribute the correction to first, induction of the remaining bone remodeling that results in a shapereforming process resulting from the activation of foot bone circumferential physeal growth and consequently, assists in attaining as much joint congruity as possible; and second, from the elongation of the soft-tissue and joint contractures that constitute the main pathology of the deformity at this age [2,3,[5][6][7][8][9][10][11][20][21][22]24,26], although other authors have postulated that this technique just distracts the contractured soft tissues, which will recontract again [33].…”

“…In the last decades, this line of treatment was studied by many researchers using different treatment modalities [3,4]. There was a consensus that 3-8-year-old children are amenable for correction by the soft-tissue distraction 'bloodless' Ilizarov technique either alone or with the adjunctive limited soft tissue release [3,[5][6][7][8][9][10][11][12]; whereas, foot osteotomies are required for older children [2,13,14]. On choosing the osteotomy type, the major V, U, Y, or supramalleolar osteotomies are convenient after puberty when foot bones become fully ossified [2,[13][14][15][16][17][18][19].…”

Doğuştan çarpık ayak: eksternal fiksatör uygulaması

“…Doğuştan çarpık ayak tedavisinde eksternal fiksatör kullanımının, minör komplikasyon oranıyla beraber, klinik ve radyografik olarak etkin bir yöntem olduğu, birçok çalışma ile gösterilmiştir. [2,[7][8][9][10][11][12][13][14][15] bileği ve ayağın posteromediyali, cilt nekrozunun gö-rülmesi en muhtemel olduğu bölgeler olarak göze çar-par ve böyle bir durumla karşı karşıya kalındığında, ilk olarak düzeltme hızı düşürülmeli, gerekirse düzelt-meye ara verilmelidir. Aynı şekilde, talar subluksasyon, distal tibial epifizin lizisi ve başta birinci parmak olmak üzere metatarsofalengeal eklem subluksasyonu açısından da, hastalar sıkı klinik ve radyografik gözleme tabi tutulmalıdırlar.…”