Correction of Severe Foot and Ankle Contracture Due to CRPS Using External Fixation and Pain Management: Report of a Pediatric Case

Mendicino, Robert W.; Kim, Chul; Kabazie, Abraham J.; Catanzariti, Alan R.

doi:10.1053/j.jfas.2008.05.010

Cited by 8 publications

(10 citation statements)

References 32 publications

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“…The distraction rate is dependent upon the local soft tissue condition and tolerance degree of patients. The soft tissue level is maintained with 1 mm/day, and it is carried out 4‐6 times a day 33‐35 . According to Equation (2) in Section 2.3, the patient's deformities can be described as an adduction deformity of γ degrees in the transverse plane, an inversion deformity of β degrees in the coronal plane, and a plantarflexion deformity of α degrees in the sagittal plane, with a limb shortening deformity along the vertical axis (tibia axis).…”

Section: Methodsmentioning

confidence: 99%

Comparison of three different correction trajectories for foot and ankle deformity treated by supramalleolar osteotomy using a novel external fixator

Dong

et al. 2020

Numer Methods Biomed Eng

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Based on the principle of distraction osteogenesis, external fixators are widely used in deformity correction of the foot and ankle. In this study, a novel ankle external fixator is proposed to correct complex multiplane deformities, especially for supramalleolar osteotomy to correct distal tibia deformities. The relatively simple structure and fewer struts in the proposed fixator reduce the complexity of adjusting the external fixator. Based on two existing adjustment strategies, a new strategy taking into account the orientation and shortest path of the ankle joint center is proposed, which is named joint adjustment for equal bone distraction. By proposing the inverse kinematic solutions of the novel external fixator, mathematical derivations of the bone trajectory and modelling of the bone shape for the three distraction strategies are performed. The results obtained by comparative analysis indicate that a uniformly spaced path of the ankle joint center can be acquired, and a smooth and uniform correction trajectory of the distal tibia end can be obtained using the new adjustment strategy. It can avoid bone end interference and only generates a maximum deviation 0.66% greater than the currently optimal 1 mm/day. The new strategy can perform multiplane corrections simultaneously, which shortens the correction time and reduces the patient's pain.

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Section: Methodsmentioning

confidence: 99%

Comparison of three different correction trajectories for foot and ankle deformity treated by supramalleolar osteotomy using a novel external fixator

Dong

et al. 2020

Numer Methods Biomed Eng

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“…There were numerous external fixation in the market and used in clinical setting including uniplanar, multiplanar, articulated or hinged, hybrid and Ilizarov frame [4,[41][42][43][44][45][46][47][48][49]. For the uniplanar external fixator, this only involves one or two rods that constructed with some number of clamps and pins.…”

Section: General Features Of the External Fixator Configurationsmentioning

confidence: 99%

The use of external fixator for ankle and foot injuries management-a review on biomechanical perspective

Ramlee¹,

Derus²

2016

Med Devices Diagn Eng

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Current clinical services are very struggling to assist the most favourable treatment for ankle and foot injuries. Therefore, this inspired researchers and engineering to investigate and explore the important of biomechanical behaviour of an external fixator. However, the understanding on biomechanical of the external fixator is important point as it can contribute to the success of injuries treatment. This review article discusses an overview of the external fixator for ankle and foot injuries management. First and foremost, this paper addresses general features of the external fixator that includes configurations, materials used and overall construct stability. In addition, we also reviewed the use of external fixator in clinical applications. In conclusion, this report suggests some recommendation for future biomechanical studies in order to provide valuable information for researchers and medical experts.

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“…2,3,5,20,25 Stiff equinovarus deformities (ECDs) of the foot are mostly caused by neglected trauma, 14,29 burns, 19,27 compartment syndrome of the leg, 5,14,16 peripheral nerve injury, 31 and central nervous system lesions. 2,23,26,30 These cosmetically challenging and functionally incapacitating deformities are common in developing countries. Moreover, because of the equinus position, these deformities are often associated with chronic metatarsalgia and/or forefoot plantar ulcers, especially in those patients with reduced sensitivity, increasing the risks of infection and amputation.…”

Section: Introductionmentioning

confidence: 99%

“…1,6,25 Poor skin quality/multiple scars, joint stiffness secondary to arthrofibrosis, shortening of the foot, claw toes, and neglected or mistreated childhood osteoarticular deformities can further complicate efforts to achieve a plantigrade foot. 1,2,3,5,[10][11][12][13]18,19,22,[23][24][25][26]28,29 Gradual and progressive correction of these severe deformities, using the distraction-osteogenesis principle proposed by Ilizarov 21 delivered through an external circular fixator, is a less invasive, yet highly effective, alternative in such cases. 5,12,13,15 According to Ilizarov, both soft tissue and bone can grow in response to gradual progressive controlled distraction force.…”

Section: Introductionmentioning

confidence: 99%

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Minimally Invasive Surgery Using the Circular External Fixator to Correct Neglected Severe Stiff Equinocavus Foot Deformities

Costa

Lotti

Pistorello

2018

Foot & Ankle Orthopaedics

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Background: Stiff equinocavus deformities of the foot are challenging to treat, often requiring extensive soft tissue dissection and bone removal. These procedures frequently yield suboptimal results and not infrequently amputation. Minimally invasive surgery using a circular external fixator potentially avoids the trauma to the soft tissue and may lead to improvement in outcomes and a lower amputation rate. The objective of this study was to evaluate the efficacy of minimally invasive surgery using a circular external fixator and limited soft tissue release to correct stiff equinocavus deformities. Methods: The treatment outcome of 29 patients (31 feet) with stiff equinocavus deformities of the foot and ankle treated with minimally invasive surgery and circular external fixation were reviewed after a mean follow-up period of 63 months. Patients' demographics and cause of the deformities were recorded. Weight bearing radiographs of the foot were compared pre and postoperatively. Results: Outcome was satisfactory (plantigrade foot with improvement/resolution of pain) in 21 of 31 extremities, fair in 6 of 31 extremities, and poor in 4 of 31 extremities. In the majority of patients, a significant improvement in the equinocavus deformities was achieved with a statistically significant improvement in calcaneus and navicular height. Two patients with Charcot-Marie-Tooth and severely insensate feet had a poor outcome, resulting in transtibial amputation. Conclusion: Minimally invasive surgery with gradual correction of neglected stiff equinocavus deformities using a modular circular external fixator is a reliable initial limb salvage strategy. Minimally invasive surgery and gradual correction of neglected severe stiff equinocavus deformities using the modular circular external fixator to gradually correct neglected severe stiff equinocavus deformities, is a safe initial limb salvage strategy which may simplify secondary procedures such as arthrodesis. Level of evidence: IV.

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Correction of Severe Foot and Ankle Contracture Due to CRPS Using External Fixation and Pain Management: Report of a Pediatric Case

Cited by 8 publications

References 32 publications

Comparison of three different correction trajectories for foot and ankle deformity treated by supramalleolar osteotomy using a novel external fixator

Comparison of three different correction trajectories for foot and ankle deformity treated by supramalleolar osteotomy using a novel external fixator

The use of external fixator for ankle and foot injuries management-a review on biomechanical perspective

Minimally Invasive Surgery Using the Circular External Fixator to Correct Neglected Severe Stiff Equinocavus Foot Deformities

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