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Recurrence after correction of acquired ankle equinus deformity in children using Ilizarov technique.

Emara KM, Allam MF, Elsayed MN, Ghafar KA - Strategies Trauma Limb Reconstr (2008)

Bottom Line: We compared the recurrence and the size of deformity between the two groups.The rate of recurrence, degree of equinus at recurrence and number of episodes of external fixation surgery showed statistical significant differences (P < 0.01) between the groups.The use of an AFO until skeletal maturity can decrease the risk and degree of recurrence.

View Article: PubMed Central - PubMed

Affiliation: Department of Orthopedic Surgery, Ain Shams University Hospitals, 13 B Kornesh El Nile, Agha Khan, Cairo, Egypt, kmemara@hotmail.com.

ABSTRACT
To describe our Ilizarov technique for the treatment of acquired equinus deformity in children and to determine if compliance with continuous use of an ankle foot orthosis (after removal of the fixator and until skeletal maturity) can influence the severity of recurrence. A cohort of 26 children with post-traumatic or post-burn contractures producing an equinus deformity was followed up for a minimum of 2 years after skeletal maturity. Cases with a bony deformity and/or nerve injury were excluded from this study. All patients were managed by a percutaneous tendo-Achilles lengthening followed by application of an Ilizarov external fixator. Post-operative treatment was in the form of gradual correction at a rate of 0.5 mm per day. Correction started from the second postoperative day until an over-correction of 15 degrees dorsiflexion was achieved. Ankle range of movement was encouraged 4 weeks prior to removal of the external fixator. On removal of the fixator, a posterior splint was applied until substituted by an ankle foot orthoses (AFO). The AFO was used continuously during the first 2-3 months and at nighttime thereafter until skeletal maturity. Fifteen children were compliant with the use of the AFO until skeletal maturity and 11 non-compliant. We compared the recurrence and the size of deformity between the two groups. The rate of recurrence, degree of equinus at recurrence and number of episodes of external fixation surgery showed statistical significant differences (P < 0.01) between the groups. The Ilizarov technique for treatment of acquired equinus deformity secondary to soft tissue scarring is a safe and effective technique. The use of an AFO until skeletal maturity can decrease the risk and degree of recurrence.

No MeSH data available.


Related in: MedlinePlus

A case of 10-year-old boy with post traumatic soft tissue loss managed by multiple surgeries with secondary fixed equines due to soft tissue scarring
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Fig1: A case of 10-year-old boy with post traumatic soft tissue loss managed by multiple surgeries with secondary fixed equines due to soft tissue scarring

Mentions: Fifty-six cases with equinus deformity in skeletally immature patients were referred for treatment by the Ilizarov technique between the year 2000 and 2004. Twenty-six were post-traumatic or post-burn contractures with a minimum follow-up of 2 years after skeletal maturity. The inclusion criteria included soft tissue contractures without associated bone deformity or nerve injury (Fig. 1). Exclusion criteria were skeletally mature patients at first presentation, polio and cerebral palsy patients, associated bone deformity or joint destruction, epiphyseal injuries causing deformity and open or infected wounds. Initial assessment included a history and physical examination together with plain radiographs of both ankles and feet to exclude associated bone deformity [1, 11].Fig. 1


Recurrence after correction of acquired ankle equinus deformity in children using Ilizarov technique.

Emara KM, Allam MF, Elsayed MN, Ghafar KA - Strategies Trauma Limb Reconstr (2008)

A case of 10-year-old boy with post traumatic soft tissue loss managed by multiple surgeries with secondary fixed equines due to soft tissue scarring
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC2599800&req=5

Fig1: A case of 10-year-old boy with post traumatic soft tissue loss managed by multiple surgeries with secondary fixed equines due to soft tissue scarring
Mentions: Fifty-six cases with equinus deformity in skeletally immature patients were referred for treatment by the Ilizarov technique between the year 2000 and 2004. Twenty-six were post-traumatic or post-burn contractures with a minimum follow-up of 2 years after skeletal maturity. The inclusion criteria included soft tissue contractures without associated bone deformity or nerve injury (Fig. 1). Exclusion criteria were skeletally mature patients at first presentation, polio and cerebral palsy patients, associated bone deformity or joint destruction, epiphyseal injuries causing deformity and open or infected wounds. Initial assessment included a history and physical examination together with plain radiographs of both ankles and feet to exclude associated bone deformity [1, 11].Fig. 1

Bottom Line: We compared the recurrence and the size of deformity between the two groups.The rate of recurrence, degree of equinus at recurrence and number of episodes of external fixation surgery showed statistical significant differences (P < 0.01) between the groups.The use of an AFO until skeletal maturity can decrease the risk and degree of recurrence.

View Article: PubMed Central - PubMed

Affiliation: Department of Orthopedic Surgery, Ain Shams University Hospitals, 13 B Kornesh El Nile, Agha Khan, Cairo, Egypt, kmemara@hotmail.com.

ABSTRACT
To describe our Ilizarov technique for the treatment of acquired equinus deformity in children and to determine if compliance with continuous use of an ankle foot orthosis (after removal of the fixator and until skeletal maturity) can influence the severity of recurrence. A cohort of 26 children with post-traumatic or post-burn contractures producing an equinus deformity was followed up for a minimum of 2 years after skeletal maturity. Cases with a bony deformity and/or nerve injury were excluded from this study. All patients were managed by a percutaneous tendo-Achilles lengthening followed by application of an Ilizarov external fixator. Post-operative treatment was in the form of gradual correction at a rate of 0.5 mm per day. Correction started from the second postoperative day until an over-correction of 15 degrees dorsiflexion was achieved. Ankle range of movement was encouraged 4 weeks prior to removal of the external fixator. On removal of the fixator, a posterior splint was applied until substituted by an ankle foot orthoses (AFO). The AFO was used continuously during the first 2-3 months and at nighttime thereafter until skeletal maturity. Fifteen children were compliant with the use of the AFO until skeletal maturity and 11 non-compliant. We compared the recurrence and the size of deformity between the two groups. The rate of recurrence, degree of equinus at recurrence and number of episodes of external fixation surgery showed statistical significant differences (P < 0.01) between the groups. The Ilizarov technique for treatment of acquired equinus deformity secondary to soft tissue scarring is a safe and effective technique. The use of an AFO until skeletal maturity can decrease the risk and degree of recurrence.

No MeSH data available.


Related in: MedlinePlus