Abstract
Introduction
Although the standard treatment of clubfoot deformity is conservative by serial casting techniques, relapses are not uncommon. Management of relapsed clubfoot deformity in older children is an orthopedic challenge. There is a growing interest in management of such complex deformities using the Ilizarov technique.
Patients and methods
In this study, the Ilizarov frame was used to correct severe relapsed clubfoot deformities in older children, who underwent previous surgical interventions. Forty-two relapsed clubfeet were included. The Dimeglio classification was used for clinical assessment of the relapsed feet preoperatively as well as postoperatively.
Results
According to the Beatson and Pearson’s numerical assessment, favorable results (excellent or good) were found in 37 feet, while poor results took place in only five feet.
Conclusions
Based on the final clinical and radiographic results, the Ilizarov technique could be considered as a good management alternative for such severe deformities.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Stephens MM (2001) Congenital talipes equinovarus. Foot Ankle Surg 7:195
Matuszewski L, Gil L, Karski J (2012) Results of treatment for congenital clubfoot using the Ponseti metnod. Eur J Orthop Surg Traumatol 22(5):403–406
Kumar MN, Gopalakrishna C (2012) Modified Ponseti method of management of neonatal club feet. Acta Orthop Belg 78(2):210–215
Marleix S, Chapuis M, Fraisse B, Tréguier C, Darnault P, Rozel C, Rayar M, Violas P (2012) Idiopathic club foot treated with the Ponseti method. Clinical and sonographic evaluation of Achilles tendon tenotomy. A review of 221 club feet. Orthop Traumatol Surg Res 98(4 Suppl):S73–S76
McKay SD, Dolan LA, Morcuende JA (2012) Treatment results of late relapsing idiopathic clubfoot previously treated with the Ponseti method. J Pediatr Orthop 32(4):406–411
Makhdoom A, Qureshi PA, Jokhio MF, Siddiqui KA (2012) Resistant clubfoot deformities managed by the Ilizarov distraction histogenesis. Indian J Orthop 46(3):326–332
Eidelman M, Keren Y, Katzman A (2012) Correction of residual clubfoot deformities in older children using taylor spatial frame and midfoot gigli saw osteotomy. J Pediatr Orthop 32(5):527–533
Zionts LE, Sangiorgio SN, Ebramzadeh E, Morcuende JA (2012) The current management of idiopathic clubfoot revisited: results of a survey of the POSNA membership. J Pediatr Orthop 32(5):515–520
Wimberly RL (2005) Idiopathic clubfoot. Curr Orthop 16:451–456
Dimeglio A, Bensahel H, Bennet F (1995) Classification of club foot. J Pediatr Orthop B 4:129–136
Ghali NN, Smith RB, Clayden AD, Silk F (1983) The results of pantalar reduction in the management of congenital talipes equinvarus. J Bone Joint Surg 65-B:1–7
Ponseti IV (1992) Treatment of congenital club foot. J Bone Joint Surg 74-A:448–454
El-Sayed MM, Seleem OA (2010) Hind-foot correction and stabilization by pins in plaster after surgical release of talipes equino varus feet in older children. J Orthop Surg Res 5(42):2–8
Daniels TR, Alman B, Wedge JH (1999) Congenital clubfoot. Curr Orthop 13:229–236
Uglow MG, Clarke NM (2000) Relapse in staged surgery for congenital talipes equinovarus. J Bone Joint Surg 82-Br:739–743
Pandey S (2002) Neglected clubfoot. Foot 12(3):123–141
Refai MA, Song SH, Song HR (2012) Does short-term application of an Ilizarov frame with transfixion pins correct relapsed clubfoot in children? Clin Orthop Relat Res 470(7):1992–1999
Oganesyan OV, Istomina IS, Kusmin VI (1996) Treatment of equinocavovarus deformity with the use of a hinged distraction apparatus. J Bone Joint Surg 87-A:546–556
Bradish CF, Noor S (2000) The Ilizarov method in the management of relapsed clubfeet. J Bone Joint Surg 82-B:387–391
Hosny GA (2002) Correction of foot deformities by the Ilizarov method without corrective osteotomies or soft tissue release. J Pediatr Orthop B 11:121–128
El Barbary H, Abdel Ghani H, Hegazy M (2004) Correction of relapsed clubfoot using a simple Ilzarov frame. Int Orthop 21:31–38
Correll J, Forth A (1996) Correction of severe clubfoot by ilizarov method. Foot Ankle Surg 2:27–32
Mayer G, Seidlein H, Hunfeld T (1996) Clubfoot correction by external ring fixator. Foot Ankle Surg 2:223–227
Galante VN, Molfetta L, Simone C (1995) The treatment of clubfoot with external fixation. Curr Orthop 9:185–188
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
El-Sayed, M.M.H. Management of severe relapsed clubfeet in older children by the Ilizarov external fixation. Eur Orthop Traumatol 4, 27–33 (2013). https://doi.org/10.1007/s12570-012-0143-5
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s12570-012-0143-5