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Management of neglected clubfoot in children using Ilizarov external fixator and minimal invasive surgery, Sub-Saharan Africa experience

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Abstract

Purpose

To evaluate the outcomes of Ilizarov external fixator (IEF) and minimal invasive surgery (MIS) in correction of neglected club foot (NCF).

Methods

Thirty-seven feet in 24 child, between five and 15 years old were diagnosed as NCF. All were treated with Achilles tendon lengthening (ATL) and IEF for gradual correction. After IEF removal, cast was applied for six weeks to maintain correction of the deformity.

Results

There were 20 boys and four girls. Seven children had left (Lt), four children had right (Rt) while 13 children had bilateral foot deformity. The mean age at surgery was 10.3 (range 5–15) years with an average follow-up of 32.5 (range 24–96) months. All feet were graded as severe according to Pirani score. All feet were corrected after an average six weeks in IEF. After two years follow-up, 23 feet (16 patients) showed good results, five feet (3 patients) showed fair results and four feet (2 patients) had Rt side foot fair result while the Lt foot had good result in both patients. Five feet (3 patients) showed poor results. Eight patients had pin site infection. One case had infected skin and subcutaneous tissue and needed debridement. Two cases developed skin sloughing, changes in color and needed close follow-up.

Conclusion

We recommend combined IEF and MIS as a suitable, efficient and successful salvage procedure in the management of severe idiopathic NCF in children especially in developing countries.

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Data availability

The authors agree to present any data need to explain any need or questions.Copyright Transfer Statement.

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Acknowledgements

We are grateful to the SICOT scientific committee who accepted to present the initial results of this work in the 34th SICOT Orthopaedic world congress held in Hyderabad, India 17–19 October 2013.

This work was done based on cases examined and operated in Egyptian Hospital, Mogadishu, Somalia between March 2012 and April 2013.

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Authors and Affiliations

  1. Orthopaedic and Trauma Surgery, Minia University, Minia, Egypt

    Mohamed Fadel

  2. Orthopaedic Department, Nizwa Hospital, Nizwa, Oman

    Mohamed Fawzy Kandil

Authors
  1. Mohamed Fadel
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  2. Mohamed Fawzy Kandil
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Contributions

Both authors contributed to the study conception and design, material preparation, data collection, analysis read and approved the final manuscript, were performed by both authors.

Corresponding author

Correspondence to Mohamed Fadel.

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Informed consent was obtained from all individual participants included in the study.

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Informed consent was obtained from all individual participants to publish the research. The authors affirm that human research participants provided informed consent for publication of the images in Figures: 1a, 1b, 1c, 1d, 1e; 2a, 2b, 2c, 2d, 2e, 2f.

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The authors declare no competing interests.

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Fadel, M., Kandil, M.F. Management of neglected clubfoot in children using Ilizarov external fixator and minimal invasive surgery, Sub-Saharan Africa experience. International Orthopaedics (SICOT) 46, 125–132 (2022). https://doi.org/10.1007/s00264-021-05123-0

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