Abstract
Introduction and Aims: Recurrence of clubfoot deformity occurs in up to 25% of cases following surgery. The Ilizarov fixator has theoretical advantages over conventional revision surgery in feet with scarred tissue planes, abnormal anatomy and impairment of local blood supply. In addition, limb-length discrepancy can be addressed simultaneously.
The aim of the study was to assess the outcome of treatment of recurrent clubfoot deformity using the Ilizarov frame.
Method: There were 39 feet in 31 patients with at least 12 months follow-up. All patients completed questionnaires documenting pain, function and shoe-size before and after the frame. Twenty-six feet were reviewed clinically. Patient notes and radiographs of all patients were examined. The average period of follow-up was 48 months (14–131 months).
Results: Pain scores improved in 69%, with similar improvement in activity level, walking distance and walking surface. In 20 feet there was improvement in the type of shoes worn. Twenty patients felt their feet were stiffer after the frame. Patient satisfaction with outcome was 74%. A plantigrade foot was achieved initially in all, but deteriorated with time, so that at clinical review only 46% had plantigrade feet. A straight medial border was seen in 81%. The range of movement of ankle and sub-talar joints decreased after the frame. Recurrent deformity was present in 38%, being more likely in younger patients, but in only a few, has further surgery been necessary to date. Complications included minor pin-site infections, flexion contractures of the toes, revision of the frame and revision of one osteotomy.
Conclusion: Treatment of relapsed clubfoot with the Ilizarov frame improves the appearance of the foot, correlating with improvement in pain, function and shoewear. This must be balanced against an increase in stiffness of the ankle, which has implications for future surgery, and the risk of complications inherent in the technique.
These abstracts were prepared by Editorial Secretary, George Sikorski. Correspondence should be addressed to Australian Orthopaedic Association, Ground Floor, The William Bland Centre, 229 Macquarie Street, Sydney, NSW 2000, Australia.
None of the authors is receiving any financial benefit or support from any source.
