Ilizarov technique and limited surgical methods for correction of post-traumatic talipes equinovarus in children

Abstract

Background:

The objective of this study was to evaluate the efficacy and safety of using Ilizarov invasive distraction technique combined with limited surgical operations in the treatment of post-traumatic talipes equinovarus in children.

Methods:

Eighteen cases of post-traumatic deformed feet in 15 patients who received the treatment of Ilizarov frame application, limited soft-tissue release or osteotomy were selected in this study. After removal of the frame, an ankle–foot orthosis was used continuously for another 6–12 months. Pre- and post-operatively, the International Clubfoot Study Group (ICFSG) score was employed to evaluate the gait and range of motion of the ankle joint. Radiographical assessment was also conducted.

Results:

Patients were followed up for 22 (17–32) months. Ilizarov frame was applied for a mean duration of 5.5 (4–9) months. When it was removed, the gait was improved significantly in all the patients. The correction time was 6–8 weeks for patients who underwent soft-tissue release and 8–12 weeks for those with bone osteotomy. At the last follow-up assessment, the differences between pre- and post-operative plantar-flexion angle, dorsiflexion, motion of ankle joint and talocalcaneal angle were significant (all P < 0.05). The observed complications included wire-hole infection in one foot, toe contracture in one, residual deformity in three, recurrence of deformity in two and spastic ischaemia in one foot.

Conclusion:

Our findings suggest that Ilizarov technique combined with limited surgical operation can be considered as an efficient and successful method for correction of post-traumatic talipes equinovarus in children.