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Application of the Ilizarov Technique to the Correction of Neurologic Equinocavovarus Foot Deformity

  • Clinical Research
  • Published:
Clinical Orthopaedics and Related Research®

Abstract

Background

The treatment of rigid equinocavovarus foot deformities caused by neurologic disorders is often difficult and relapse is common.

Questions/purposes

We asked whether the Ilizarov technique could be used for correction of neurologic equinocavovarus foot deformities resulting in improved foot and ankle function and patient satisfaction.

Patients and Methods

The neurologic equinocavovarus foot deformities of 26 patients (mean age, 18.7 years; 29 feet) were treated using the Ilizarov technique. Nine feet were treated by distraction histiogenesis only with limited soft tissue release, whereas 20 feet needed additional osteotomy and/or tendon transfer/lengthening. Minimum followup was 12 months (mean, 72.9 months; range, 12–155 months).

Results

The mean time required for deformity correction was 27.1 days (range, 14–47 days) and the mean time for stabilization in the apparatus was 23.2 days (range, 7–53 days). A painless, stable, and plantigrade result was obtained by 22 patients (24 feet). Mild residual foot deformity was observed in the remaining five feet of four patients. Six patients (six feet) experienced postoperative complications. Three patients (four feet) experienced recurrence of the deformity requiring surgical correction.

Conclusions

Ilizarov soft tissue distraction with or without callotasis of tarsal bone(s) allows a greater degree of correction of neurologic equinocavovarus foot deformities. However, to reduce the risk of recurrence after fixator removal, it may be necessary to overcorrect the deformity while in the fixator, to use nighttime splinting, and most importantly, to eliminate neuromuscular imbalance, if necessary, by combining arthrodesis with or without tendon transfer.

Level of Evidence

Level IV, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.

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Acknowledgments

We thank Tae Yoon Kim MD, for assistance with data collection.

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Correspondence to In Ho Choi MD.

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Each author certifies that he or she has no commercial associations (eg, consultancies, stock ownership, equity interest, patent/licensing arrangements, etc) that might pose a conflict of interest in connection with the submitted article.

Each author certifies that his or her institution approved the human protocol for this investigation and that all investigations were conducted in conformity with ethical principles of research.

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Lee, D.Y., Choi, I.H., Yoo, W.J. et al. Application of the Ilizarov Technique to the Correction of Neurologic Equinocavovarus Foot Deformity. Clin Orthop Relat Res 469, 860–867 (2011). https://doi.org/10.1007/s11999-010-1497-z

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  • DOI: https://doi.org/10.1007/s11999-010-1497-z

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