Relapsed clubfoot correction with soft-tissue release and selective application of Ilizarov technique

Malizos, Konstantinos N.; Gougoulias, Nikolaos; Dailiana, Zoe; Rigopoulos, Nikolaos; Moraitis, T.

doi:10.1007/s11751-008-0049-5

Cited by 14 publications

(16 citation statements)

References 36 publications

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“…In children, correction is achieved without the need for soft tissue release, tendon lengthening, or osteotomies [21].The Ilizarov protocol consisted of correction of all elements of the deformity, followed by maintenance of the frame in the corrected position for 4 to 10 weeks, to achieve stabilization of the correction [3,16]. Thus, the Ilizarov technique has been considered a time-consuming procedure, with the additional disadvantages of complicated frame arrangement, pin tract infection, and lack of patient and parent compliance [9].…”

Section: Introductionmentioning

confidence: 99%

Does Short-term Application of an Ilizarov Frame with Transfixion Pins Correct Relapsed Clubfoot in Children?

Refai

Song

2012

Clinical Orthopaedics &Amp; Related Research

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Background Treatment of relapsed clubfoot after soft tissue release in children is difficult because of the high recurrence rate and related complications. Even though the Ilizarov method is used for soft tissue distraction, there is a high incidence of recurrence after removal of the Ilizarov frame owing to previous contracture of soft tissue and a skin scar. Questions/Purposes We asked (1) whether transfixation of midfoot joints by temporary K wires during the consolidation stage after short-term application of an Ilizarov frame would maintain correction of the relapsed clubfoot clinicoradiologically and (2) whether this method would reduce the rate of recurrence and related complications in patients with a skin scar from previous surgery.

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Section: Introductionmentioning

confidence: 99%

Does Short-term Application of an Ilizarov Frame with Transfixion Pins Correct Relapsed Clubfoot in Children?

Refai

Song

2012

Clinical Orthopaedics &Amp; Related Research

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“…Upto 4-10 years age group of CTEV deformities-we perform soft tissue release surgeries, which may be combined with bony corrective surgeries like cuboid enucleation and cuboidectomy. In soft tissue release surgeries, posteromedial release, tendoachilis lengthening, steindlars with ankle and sub talar capsulotomy, z plasty of medial tendons, tibialis anterior transfer laterally done for recurrent CTEV (7). We observed that avoiding single long incision in camp surgeries prevents sloughing of skin and having incision on medial and posterior side with breech of skin gives good results.…”

Section: Conservative Managementmentioning

confidence: 79%

“…Above the age group 10 years patients, -soft tissue release surgeries (7) with wedge resection of tarsal bone were performed to correct persistent varus deformity. (8) Base of wedge is dorsolateral and incision given distally through cuboid and proximal to distal pole of calcaneum and neck of talus.…”

Section: Conservative Managementmentioning

confidence: 99%

Corrective Surgery in Congenital Talipes Equinovarus Deformity: A Camp Approach

Benn¹,

Verma²,

Deshkar³

et al. 2015

jebmh

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The study was intended to assess the results of soft tissue release and bony corrective surgery in patients of moderate to severe deformed rigid club foot (CTEV) and neglected clubfoot (CTEV) at free disabled surgical camps at Chhattisgarh state. MATERIAL AND METHODS: In our study 50 patients were included with 70% male and 30% female with 4-16 years of age group and 70% unilateral and 30% bilateral foot involvement. Patients were admitted and operated in different free disabled surgical camps at Chhattisgarh state over the period of 36 months (1 may 2004 to 30 th April 2007). Improvement in functional ability and locomotion of all operated patients were assessed by physical and clinical examination. RESULTS: All patients who were operated in our study showed significant improvement in functional ability and locomotion after surgery. All patients were maintaining functional ability at follow up duration of 12 months (1 year). 75% patients were walking normally, 10% cases were walking with internal rotation of leg and 5% cases were walking with midtarsal varus foot with AFO with medial bar support. CONCLUSION: Our study showed and established that excellent results can be obtained in congenital talipes equinovarus (CTEV) patients by soft tissue release with bony corrective surgery. The team work of devoted surgeons, paramedical and rehabilitation staff in whole duration of camps to achieve the goal. With an aim to help more number of CTEV cases by surgery, our team has started doing surgeries in small institutions, and organize charity camps to help poor patients and mankind even in small clinics. INTRODUCTION: The commonly called clubfoot is scientifically called congenital talipes equinovarus has a tendency to show relapse irrespective of the treatment either with conservative management or surgical management, and was described by Hippocrates in 400 BC. Congenital talipes equino varus (CTEV) deformity is most common congenital disability of the foot in our country. (1) In every 1000 birth one child is having CTEV. (2) CTEV may be associated with joint laxity, congenital dislocation of the hip, tibial torsion, ray anomalies of the foot absences of some tarsal bones and a history of other foot anomalies in the family. (3) Of all these bones most relevant for this congenital deformity are the talus, calcaneus and navicular. The calcaneus and navicular are medially rotated in relation to the talus. The foot is held in adduction and inversion by ligaments and muscles. (4) Cases of congenital talipes equino varus are neglected due to illiteracy, poverty, ignorance and lack of proper health services especially in villages. A disabled person in the family becomes nonearning and seems to be burden to family unless rehabilitated. Conservative management plays vital role and becomes useful if reported early. Ponseti technique

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“…These ranged from just using soft-tissue distraction alone to achieve joint realignment (closed 'bloodless' technique) [2,3,[5][6][7][8][9][10][11][20][21][22]24,26] to the use of an adjunctive soft tissue release, foot distraction osteotomies, or both [2,[12][13][14][15][16][17][18][19]23,[27][28][29][30][31][32][33][34][35][36].…”

Section: Discussionmentioning

confidence: 99%

Ilizarov techniques with limited adjunctive surgical procedures for the treatment of preadolescent recurrent or neglected clubfeet

Khanfour

2013

Journal of Pediatric Orthopaedics B

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When choosing the Ilizarov technique for the treatment of recurrent or neglected clubfeet deformity, there was a consensus on the treatment of 3-8-year-old children by the soft-tissue distraction 'bloodless method' either alone or with an adjunctive-limited soft tissue release; whereas, in older children, adjunctive osteotomies were required. Major foot osteotomies such as V, U, Y, or supramalleolar types were established for patients after puberty when the foot bones become fully ossified. So, children falling in the age group between 8 and 13 years (preadolescents) represents a transitional growing stage that has its identity that makes carrying out major foot osteotomies unsuitable. Twenty-five feet in 21 patients with a mean age at the time of operation of 10.9 years (range, 9-13 years) with recurrent or neglected clubfeet deformity who presented to the orthopedic department at Alexandria (Egypt) between February 2004 and December 2008 were treated with the Ilizarov technique combined with adjunctive limited bony and/or soft-tissue procedures as will be discussed. After a mean follow-up period of 3.6 years (range, 2-7 years), 21 children showed good results, four children showed fair results, and no poor results were recorded. No major complications were reported. The Ilizarov technique with limited bony and/or soft-tissue procedures can be considered as a suitable, convenient, efficient, and successful salvage procedure for preadolescent recurrent or neglected clubfeet.

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Relapsed clubfoot correction with soft-tissue release and selective application of Ilizarov technique

Cited by 14 publications

References 36 publications

Does Short-term Application of an Ilizarov Frame with Transfixion Pins Correct Relapsed Clubfoot in Children?

Does Short-term Application of an Ilizarov Frame with Transfixion Pins Correct Relapsed Clubfoot in Children?

Corrective Surgery in Congenital Talipes Equinovarus Deformity: A Camp Approach

Ilizarov techniques with limited adjunctive surgical procedures for the treatment of preadolescent recurrent or neglected clubfeet

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