Ilizarov external fixator for correction of complex foot deformities
Osman Tecimel1, Ali Öçgüder1, Metin Doğan2, Mahmut Uğurlu2, Murat Bozkurt2, Sabri Ateşalp3
1Department of Orthopedics and Traumatology, Atatürk Training and Research Hospital, Ankara, Turkey
2Department of Orthopedics and Traumatology, Medicine Faculty of Yıldırım Beyazıt University, Ankara, Turkey
3Department of Orthopedics and Traumatology, Gülhane Military Medical Academy, Ankara, Turkey
Keywords: Foot deformity, Ilizarov external fixator, surgical treatment.
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 three dimensional characteristic of the foot and fixator in the correction of complicated foot deformities.