[Correction of severe deformities of the foot, using Ilizarov's equipment]

Abstract

Material and methods: 38 feet in 36 patients who underwent a progressive foot correction without osteotomies, with an Ilizarov frame have been reviewed. There were 23 equinovarus, 2 equinovalgus, 13 equinus deformities. In 20 patients, the deformity had relapsed after one to four previous operations. The mean follow-up was 22 (12-35) months. The mean age was 17 years (6-68). There were 15 females and 21 males.

Results: All but 4 patients were satisfied with the result, although 15 still had pain during daily activities. The shape of the feet was distinctly improved in all patients, although residual equinus was found in 6 patients, residual varus in 2 and forefoot problems in 6. Pintract infections were encountered in half of the patients, all settled with local treatment, adjustement of the tension of the wires and antibiotics. Three specific complications were encountered: talus subluxations (7), toe contractures (6), relapse of equinus (4).

Discussion: Few alternatives are available to correct severe foot deformities. Soft tissue releases and/or wedge osteotomies are technically demanding, cause shortening of the foot, correct only one predominant component, are contraindicated in patients with infections or a poor vascular or skin condition. Progressive correction by the Ilizarov method is a valuable alternative, although we would like to stress the importance of some details in order to avoid the specific complications. Progressive correction of foot deformities by the Ilizarov frame is demanding for patient and surgeon. It should be reserved for the indications mentioned earlier and also for foot deformities combined with shortening or axial deviations.