Management of the Neuromuscular Foot Deformities with the Llizarov Method

Küçükkaya, Metin; Kabukçuoğlu, Yavuz; Kuzgun, Unal

doi:10.1177/107110070202300210

Cited by 31 publications

(20 citation statements)

References 11 publications

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“…Furthermore, soft tissue viability and function can be assessed directly, and the rate of correction can be adjusted accordingly [5]. In case of acute correction combined with talectomy, the talus should be removed completely and sometimes all or part of the navicula also should be removed to achieve adequate correction [17,22]. Although it was reported [18,22] that walking ability could be preserved after talectomy, movement of the foot at the tibiotalar pseudarthrosis and midtarsal joint was severely limited and the foot height was low and the foot length was short.…”

Section: Discussionmentioning

confidence: 99%

“…Treatment of a rigid neurologic foot deformity is rather difficult and relapse of the deformity is a common problem [5]. The goal of treatment for a neurologic rigid foot deformity is to convert a deformed, rigid structure into a stable, plantigrade foot [5,17]. Soft tissue release combined with osteotomies is the preferred treatment.…”

Section: Introductionmentioning

confidence: 99%

“…Upper and lower motor neuron diseases such as cerebral palsy, spina bifida, arthrogryposis, and residual poliomyelitis often cause severe and rigid deformities in the foot and ankle [16,17,19]. Treatment of a rigid neurologic foot deformity is rather difficult and relapse of the deformity is a common problem [5].…”

Section: Introductionmentioning

confidence: 99%

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

Lee

Choi

Yoo

et al. 2011

Clinical Orthopaedics &Amp; Related Research

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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

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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

Lee

Choi

Yoo

et al. 2011

Clinical Orthopaedics &Amp; Related Research

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“…[1,7,9,10,14] The complication rates are reported to be high in the treatments by external fixators. [1,9,10,[18][19][20] This is due to the fact that the Ilizarov external fixator is not well known and that the minor complications are frequent. For example, the pin tract infection is a serious problem.…”

Section: Discussionmentioning

confidence: 99%

Ilizarov external fixator for correction of complex foot deformities

Tecimel¹,

Öçgüder²,

Doğan

et al. 2013

Eklem Hastalik Cerrahisi

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Amaç: Bu çalışmada karmaşık ayak deformitelerinin düzel-tilmesinde İlizarov eksternal fiksatörünün sonuçları değer-lendirildi. Hastalar ve yöntemler: Ocak 2000 ile Eylül 2005 tarihleri arasında kliniğimizde karmaşık ayak deformitesi nedeniyle İlizarov eksternal fiksatörü uygulanan 25 hastanın (18 erkek, 7 kadın; ort. yaş 13.7 yıl; dağılım 5-24 yıl) 29 ayağı prospektif olarak değerlendirildi. Dört hastada iki taraflı ayak deformitesi vardı. Deformitelerin dağılımı şu şekildeydi: 29 ayakta arka ayak inversiyon (kalkaneovarus), 29 ayakta ön ayak ekin (cavus), 28 ayakta ön ayak adduksiyon, 27 ayakta ön ve arka ayak supinasyonu ve bir ayakta ön ve arka ayak pronasyonu vardı. Ortalama hastanede kalış süresi 9.4 hafta (dağılım, 6-18 hafta) idi. Yaşları 13-24 arası olan dokuz hastada osteotomi gereksinimi oldu. Altı hastada orta subtalar osteotomi uygulanırken, üç hastada subtalar osteotomi uygulandı. Üç hastada kesi yerindeki skar dokusunun çıkarılması ile gevşetme sağ-landı. Ortalama takip süresi 48 ay (dağılım, 16-65 ay) idi. Bulgular: Hastaların tedavi süresi ortalama 21.6 hafta (dağı-lım, 13-31 hafta) idi. Tüm hastalar tedaviden sonra daha iyi yürüdü. Paley kriterlerine göre, 27 ayak plantigrade (düz basma), iki ayak ise plantigrade olmayan (düz basamayan) olarak değerlendirildi. İki hastanın ağrısı vardı. Tedavinin başarı oranı %86.2 idi. Sonuç: İlizarov yöntemi, karmaşık ayak deformitelerinin düzeltilmesinde, ayağın ve fiksatörün üç boyutlu özelliği sayesinde, etkili bir yaklaşım olarak görülmek-tedir.Anahtar sözcükler: Ayak deformitesi, İlizarov eksternal fiksatör, cerrahi tedavi.Objectives: This study aims to evaluate the outcomes of the Ilizarov external fixator for the correction of complex foot deformities. Patients and methods: Between January 2000 and September 2005, 29 feet of 25 patients (18 males, 7 females; mean age 13.7 years; range 5 to 24 years) who were applied Ilizarov external fixators due to complex foot deformities in our clinic were prospectively analyzed. Four patients had bilateral foot deformity. The distribution of the deformities was as follows: hindfoot inversion (calcaneovarus) in 29, forefoot equines (cavus) in 29, forefoot adductus in 28, forefoot and hindfoot supination in 27 and forefoot and hindfoot pronation in one foot. The mean length of hospital stay was 9.4 weeks (range, 6 to 18 weeks). Osteotomy was required in nine patients with ages ranging from 13 to 24. Middle subtalar osteotomy was applied on six patients, while three patients received subtalar osteotomy. In three patients, release was provided by removal of incision scar tissue. The mean follow-up was 48 months (range, 16-65 months). Results: The mean treatment period was 21.6 weeks (range, 18-31 weeks). All patients walked better following treatment. According to Paley's criteria, 27 feet were evaluated as plantigrade (flat) and two as non-plantigrade (non-flat). Two patients suffered from pain. The success rate of the treatment was 86.2%. Conclusion: Ilizarov method appears to be an efficient approach thanks to the th...

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“…Entretanto, quando há muito prejuízo da sensibilidade, principalmente a profunda, ela pode provocar, em longo prazo, degenerações articulares tipo junta de Charcot (67,68) . Finalmente, para pés muito deformados, geralmente já submetidos a cirurgias e com más condições de partes moles e de pele, há possibilidade de correção seguindo os princípios da técnica de Ilizarov (69,70) . A recidiva da deformidade tem sido observada mesmo após a artrodese tríplice e é atribuída ao desequilí-brio muscular residual e à característica progressiva da doença (44,52,53,71) .…”

Section: Tratamento Cirúrgicounclassified

Pé cavo adquirido na doença de Charcot-Marie-Tooth

Maranho

Volpon

2009

Rev. bras. ortop.

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rESUMOAs neuropatias sensitivomotoras hereditárias, principalmente a doença de Charcot-Marie-Tooth, manifestam-se frequentemente com o aparecimento de pé cavovaro, deformidade caracterizada pela acentuação fixa do arco plantar e inversão do retropé. O diagnóstico da doença de base e a cuidadosa avaliação do paciente fornecem os elementos-chave para decisão do tratamento. O cavo pode situar-se no antepé, retropé ou ser o resultado da associação das duas localizações. Deformidades combinadas, principalmente varismo e garras dos artelhos, devem ser bem avaliadas; as características clínicas como grau das alterações, acometimento da força muscular, flexibilidade e idade são fatores importantes para a decisão da conduta. O tratamento conservador do pé cavovaro por meio de fisioterapia, palmilhas e adaptação nos calçados é reservado ao paciente mais jovem ou casos levemente acometidos. Entretanto, há tendência de agravamento das deformidades devido à característica progressiva da doença neurológica de base. Assim, o tratamento cirúrgico pelas técnicas clássicas é indicado precocemente, sendo importante identificar as alterações primárias, diferenciá-las das secundárias e corrigi-las, se possível. As transferências musculares são usadas no sentido de minimizar o desequilíbrio, estruturas retraídas são seccionadas ou alongadas e osteotomias localizadas devem ser preferíveis às artrodeses, que são reservadas para pés rígidos e muito deformados de pacientes adultos.

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Management of the Neuromuscular Foot Deformities with the Llizarov Method

Cited by 31 publications

References 11 publications

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

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

Ilizarov external fixator for correction of complex foot deformities

Pé cavo adquirido na doença de Charcot-Marie-Tooth

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