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Relapsed clubfoot correction with soft-tissue release and selective application of Ilizarov technique.

Malizos KN, Gougoulias NE, Dailiana ZH, Rigopoulos N, Moraitis T - Strategies Trauma Limb Reconstr (2008)

Bottom Line: Postoperative radiographic measurements revealed values that can be considered as normal.Complications included pin tract infections (12% of inserted wires).Flat-topped talus was observed in 3 feet.

View Article: PubMed Central - PubMed

Affiliation: Department of Orthopaedic Surgery, University of Thessalia, 22 Papakiriazi St, 41222, Larissa, Greece, malizos@med.uth.gr.

ABSTRACT
The Ilizarov technique is an alternative for the treatment of complex foot deformities in children. The authors retrospectively reviewed children with relapsed clubfoot deformity, treated with soft tissue procedures and additional correction with an Ilizarov frame. Twelve consecutive patients (13 feet) with relapsed clubfoot deformity after previous surgical correction were reviewed. Treatment included open releases. An Ilizarov frame was applied as an adjunct in seven patients (mean age of 7.8 years) with severe deformity where complete intraoperative correction was not achieved. Clinical and radiographic assessment was undertaken. The mean Laaveg-Ponseti score, for the 7 feet treated with the Ilizarov frame, was 85.1 after minimum 4 years follow-up. One recurrence of forefoot deformity required metatarsal osteotomies. Postoperative radiographic measurements revealed values that can be considered as normal. Complications included pin tract infections (12% of inserted wires). Flat-topped talus was observed in 3 feet. Deformity correction was possible when soft tissue procedures were combined with the use of Ilizarov technique, in order to support and gradually improve surgical correction.

No MeSH data available.


Related in: MedlinePlus

Asymptomatic, well-aligned foot in a teenager after soft tissue release and Ilizarov frame application. The left foot (arrows), initially surgically treated at the age of 3, underwent surgical treatment for relapse of his clubfoot at the age of 10 years (open arthrolysis, Achilles, FHL, FDL tendon lengthening and plantar aponeurosis release accompanied by an Ilizarov frame), achieving a Laaveg–Ponseti score of 98 after 4.5 years of follow-up
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Fig4: Asymptomatic, well-aligned foot in a teenager after soft tissue release and Ilizarov frame application. The left foot (arrows), initially surgically treated at the age of 3, underwent surgical treatment for relapse of his clubfoot at the age of 10 years (open arthrolysis, Achilles, FHL, FDL tendon lengthening and plantar aponeurosis release accompanied by an Ilizarov frame), achieving a Laaveg–Ponseti score of 98 after 4.5 years of follow-up

Mentions: The mean age of the seven patients undergoing correction with the Ilizarov technique was 7.7 years. We avoided osseous procedures. Four patients (5, 7, 8, 10 of Table 1) were younger than 8 years of age. One of these patients (case 7) developed recurrence of forefoot adduction 3 years later, despite complete initial correction (Fig. 3). For the three patients who were older than 8 years, soft tissue procedures were selected since the recurrent deformities were classified as flexible (cases 3, 9 of Table 1) (Fig. 4) or had already talonavicular arthritis and the treating surgeons decided to gradually correct the deformity by soft tissue distraction alone and to withhold the option of a triple fusion for the future (case 2).Fig. 4


Relapsed clubfoot correction with soft-tissue release and selective application of Ilizarov technique.

Malizos KN, Gougoulias NE, Dailiana ZH, Rigopoulos N, Moraitis T - Strategies Trauma Limb Reconstr (2008)

Asymptomatic, well-aligned foot in a teenager after soft tissue release and Ilizarov frame application. The left foot (arrows), initially surgically treated at the age of 3, underwent surgical treatment for relapse of his clubfoot at the age of 10 years (open arthrolysis, Achilles, FHL, FDL tendon lengthening and plantar aponeurosis release accompanied by an Ilizarov frame), achieving a Laaveg–Ponseti score of 98 after 4.5 years of follow-up
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC2599798&req=5

Fig4: Asymptomatic, well-aligned foot in a teenager after soft tissue release and Ilizarov frame application. The left foot (arrows), initially surgically treated at the age of 3, underwent surgical treatment for relapse of his clubfoot at the age of 10 years (open arthrolysis, Achilles, FHL, FDL tendon lengthening and plantar aponeurosis release accompanied by an Ilizarov frame), achieving a Laaveg–Ponseti score of 98 after 4.5 years of follow-up
Mentions: The mean age of the seven patients undergoing correction with the Ilizarov technique was 7.7 years. We avoided osseous procedures. Four patients (5, 7, 8, 10 of Table 1) were younger than 8 years of age. One of these patients (case 7) developed recurrence of forefoot adduction 3 years later, despite complete initial correction (Fig. 3). For the three patients who were older than 8 years, soft tissue procedures were selected since the recurrent deformities were classified as flexible (cases 3, 9 of Table 1) (Fig. 4) or had already talonavicular arthritis and the treating surgeons decided to gradually correct the deformity by soft tissue distraction alone and to withhold the option of a triple fusion for the future (case 2).Fig. 4

Bottom Line: Postoperative radiographic measurements revealed values that can be considered as normal.Complications included pin tract infections (12% of inserted wires).Flat-topped talus was observed in 3 feet.

View Article: PubMed Central - PubMed

Affiliation: Department of Orthopaedic Surgery, University of Thessalia, 22 Papakiriazi St, 41222, Larissa, Greece, malizos@med.uth.gr.

ABSTRACT
The Ilizarov technique is an alternative for the treatment of complex foot deformities in children. The authors retrospectively reviewed children with relapsed clubfoot deformity, treated with soft tissue procedures and additional correction with an Ilizarov frame. Twelve consecutive patients (13 feet) with relapsed clubfoot deformity after previous surgical correction were reviewed. Treatment included open releases. An Ilizarov frame was applied as an adjunct in seven patients (mean age of 7.8 years) with severe deformity where complete intraoperative correction was not achieved. Clinical and radiographic assessment was undertaken. The mean Laaveg-Ponseti score, for the 7 feet treated with the Ilizarov frame, was 85.1 after minimum 4 years follow-up. One recurrence of forefoot deformity required metatarsal osteotomies. Postoperative radiographic measurements revealed values that can be considered as normal. Complications included pin tract infections (12% of inserted wires). Flat-topped talus was observed in 3 feet. Deformity correction was possible when soft tissue procedures were combined with the use of Ilizarov technique, in order to support and gradually improve surgical correction.

No MeSH data available.


Related in: MedlinePlus