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

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.