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Resistant clubfoot deformities managed by Ilizarov distraction histogenesis.

Makhdoom A, Qureshi PA, Jokhio MF, Siddiqui KA - Indian J Orthop (2012)

Bottom Line: At the time of removal of the fixator, a plantigrade foot was achieved in 25 feet and gait was improved in all patients.Excellent and good results (74.07%) were considered satisfactory, while fair and poor results (25.92%) were considered unsatisfactory.The short term clinical and functional results of resistant clubfoot deformities with Ilizarov's external fixator is promising and apparently a good option.

View Article: PubMed Central - PubMed

Affiliation: Department of Orthopaedic Surgery and Traumatology (DOST), Liaquat University of Medical and Health Sciences Jamshoro, Sindh, Pakistan.

ABSTRACT

Background: Resistant clubfoot deformities of the foot and ankle remain a difficult problem even for the most experienced surgeon. We report a series of neglected resistant clubfoot deformities treated by limited surgery and Ilizarov distraction histogenesis.

Materials and methods: Twenty one patients with 27 feet having resistant clubfoot deformities were managed by Ilizarov distraction histogenesis from April 2005 to May 2008. The mean age was 12 years (range 8-20 years). A limited soft tissue dissection like percutaneous Achilles sheath tenotomy and plantar fasciotomy were done. Progressive correction of the deformities was achieved through the standard and simple Ilizarov frame construct setting. After removal of Ilizarov frame, a short leg walking cast was used for an additional 6 weeks, followed by an ankle foot orthrosis for 3 months.

Results: The mean followup period was 18.7 months (range 20-36 months). The mean duration of fixator application was 3.6 months (range 3-5 months). At the time of removal of the fixator, a plantigrade foot was achieved in 25 feet and gait was improved in all patients. There was residual varus hind foot deformity in two patients. Out of 27 feet, 3 (11.11%) were rated as excellent, 17 (62.96%) as good, 5 (18.51%) as fair, and 2 (7.40%) as poor according to Reinkerand Carpenter scale. Excellent and good results (74.07%) were considered satisfactory, while fair and poor results (25.92%) were considered unsatisfactory.

Conclusion: The short term clinical and functional results of resistant clubfoot deformities with Ilizarov's external fixator is promising and apparently a good option.

No MeSH data available.


Related in: MedlinePlus

(a) Preoperative clinical photograph of the feet, from the front of neglected congenital telepesequinovarus; (b) Preoperative clinical photograph of the same feet, from behind; (c) Preoperative lateral radiographs of both feet showing the deformity (d) Preoperative anteroposterior radiographs of both feet showing the deformity
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Figure 2: (a) Preoperative clinical photograph of the feet, from the front of neglected congenital telepesequinovarus; (b) Preoperative clinical photograph of the same feet, from behind; (c) Preoperative lateral radiographs of both feet showing the deformity (d) Preoperative anteroposterior radiographs of both feet showing the deformity

Mentions: Kinking of the skin with temporary edema over the callosities was noticed in 6 feet above the age of 15 years due to shortening of lateral column and resolved after 4–6 weeks after the deformity correction. Flexion deformities of toes developed due to increasing tension on the long flexor tendons during deformity correction and was controlled by toe slings, supports over forefoot, and insertion of Kwires. There were 8 feet above the age of 15 years, and the overall outcome was good in 5, fair in 2, and poor in 1 foot [Figures 2 and 3].


Resistant clubfoot deformities managed by Ilizarov distraction histogenesis.

Makhdoom A, Qureshi PA, Jokhio MF, Siddiqui KA - Indian J Orthop (2012)

(a) Preoperative clinical photograph of the feet, from the front of neglected congenital telepesequinovarus; (b) Preoperative clinical photograph of the same feet, from behind; (c) Preoperative lateral radiographs of both feet showing the deformity (d) Preoperative anteroposterior radiographs of both feet showing the deformity
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3377145&req=5

Figure 2: (a) Preoperative clinical photograph of the feet, from the front of neglected congenital telepesequinovarus; (b) Preoperative clinical photograph of the same feet, from behind; (c) Preoperative lateral radiographs of both feet showing the deformity (d) Preoperative anteroposterior radiographs of both feet showing the deformity
Mentions: Kinking of the skin with temporary edema over the callosities was noticed in 6 feet above the age of 15 years due to shortening of lateral column and resolved after 4–6 weeks after the deformity correction. Flexion deformities of toes developed due to increasing tension on the long flexor tendons during deformity correction and was controlled by toe slings, supports over forefoot, and insertion of Kwires. There were 8 feet above the age of 15 years, and the overall outcome was good in 5, fair in 2, and poor in 1 foot [Figures 2 and 3].

Bottom Line: At the time of removal of the fixator, a plantigrade foot was achieved in 25 feet and gait was improved in all patients.Excellent and good results (74.07%) were considered satisfactory, while fair and poor results (25.92%) were considered unsatisfactory.The short term clinical and functional results of resistant clubfoot deformities with Ilizarov's external fixator is promising and apparently a good option.

View Article: PubMed Central - PubMed

Affiliation: Department of Orthopaedic Surgery and Traumatology (DOST), Liaquat University of Medical and Health Sciences Jamshoro, Sindh, Pakistan.

ABSTRACT

Background: Resistant clubfoot deformities of the foot and ankle remain a difficult problem even for the most experienced surgeon. We report a series of neglected resistant clubfoot deformities treated by limited surgery and Ilizarov distraction histogenesis.

Materials and methods: Twenty one patients with 27 feet having resistant clubfoot deformities were managed by Ilizarov distraction histogenesis from April 2005 to May 2008. The mean age was 12 years (range 8-20 years). A limited soft tissue dissection like percutaneous Achilles sheath tenotomy and plantar fasciotomy were done. Progressive correction of the deformities was achieved through the standard and simple Ilizarov frame construct setting. After removal of Ilizarov frame, a short leg walking cast was used for an additional 6 weeks, followed by an ankle foot orthrosis for 3 months.

Results: The mean followup period was 18.7 months (range 20-36 months). The mean duration of fixator application was 3.6 months (range 3-5 months). At the time of removal of the fixator, a plantigrade foot was achieved in 25 feet and gait was improved in all patients. There was residual varus hind foot deformity in two patients. Out of 27 feet, 3 (11.11%) were rated as excellent, 17 (62.96%) as good, 5 (18.51%) as fair, and 2 (7.40%) as poor according to Reinkerand Carpenter scale. Excellent and good results (74.07%) were considered satisfactory, while fair and poor results (25.92%) were considered unsatisfactory.

Conclusion: The short term clinical and functional results of resistant clubfoot deformities with Ilizarov's external fixator is promising and apparently a good option.

No MeSH data available.


Related in: MedlinePlus