Treatment of Resistant Clubfoot with Soft Tissue Release and Alkhooly External Fixator

Alkhooly, Ali Zein A. A.; Mohamed, Mohamed Ali Ahmed; Ali, Ebrahim El-Hawary

doi:10.4236/ojo.2013.37058

Cited by 1 publication

(1 citation statement)

References 23 publications

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“…Subcutaneous skin expanders implantation have been reported in clubfoot with limited role in children [18], not in extreme deformities. [26] cited with complete reference in their bibliography and successfully used surgical technique of author's 1st Gen i.e. DOrsolateral LAteral Rotation (DOLAR) skin flap (Internat orthop-SICOT 1987) for correction of resistant clubfeet, but maintained initially for 4 weeks with an external fixator instead of plaster cast, with excellent/good results.…”

Section: Introduction and Review Of Literaturementioning

confidence: 99%

Trimorphic extreme clubfoot deformities and their management by triple surgical skin expanders- DOLAR, DOLARZ and DOLARZ-E (evidence based mega-corrections without arthrodesis)

2018

International Orthopaedics (SICOT)

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Aim/purpose Extreme congenital club foot deformities are common in developing countries, presenting at birth, persisting in children, adolescents and adults; as untreated/under-corrected by conservative and/or surgical means. Scores of confusing names exist in literature for such deformities with no good treatment available; mostly advocating unacceptable arthrodesis. The author researched this grey area for more than 40 years and successfully innovated improved surgical corrections, more acceptable to patients. Methods All were given a generic name: Bextreme deformities^, with 3 hierarchic grades. each 3D (trimorphic) because of their common aim: a good correction. The author started with anatomical dissections in clubfeet (zero cost), consistently reinforced with solid clinical background. Heterogeneous skin contractures, congenital with/without scars, were discovered as the primary cause with cramped deeper tissues and evolved, evidence based, 3D enlargement of skin chamber by triple expanding incisions: DOrso-LAteral Rotation skin flap (DOLAR-acronym) for grade I, DOLAR + Z-plasty (DOLARZ) for grade II and DOLAR + Z + VY-plasty (DOLARZ-E) for grade III, E means Extended. Patient satisfaction level (excellent, good, fair/poor) had been considered for grading results, rather than scoring systems because each clubfoot is different with countless variables. Results & conclusions The author operated 1080 feet during the last 40 years with long term follow up, six months to 30 years, with an average of 12½ years. The results obtained were: excellent/good (96%) and fair/poor (4% including superficial skin necrosis only in 3%, evidence based). Triple surgical skin expansion consistently resulted in longer, flexible, joints sparing, good shaped, better functioning foot; even in adults.

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Section: Introduction and Review Of Literaturementioning

confidence: 99%

Trimorphic extreme clubfoot deformities and their management by triple surgical skin expanders- DOLAR, DOLARZ and DOLARZ-E (evidence based mega-corrections without arthrodesis)

2018

International Orthopaedics (SICOT)

View full text Add to dashboard Cite

show abstract

Treatment of Resistant Clubfoot with Soft Tissue Release and Alkhooly External Fixator

Cited by 1 publication

References 23 publications

Trimorphic extreme clubfoot deformities and their management by triple surgical skin expanders- DOLAR, DOLARZ and DOLARZ-E (evidence based mega-corrections without arthrodesis)

Trimorphic extreme clubfoot deformities and their management by triple surgical skin expanders- DOLAR, DOLARZ and DOLARZ-E (evidence based mega-corrections without arthrodesis)

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