Abstract
Introduction and Aims: We report a series of 41 corrections in 36 adult patients performed for complex deformities of the foot and ankle using circular external fixation, with a mean follow-up of 4.4 years. The foot and ankle deformities were 18 hindfoot equines, two forefoot equines, six hindfoot and forefoot equines, eight equinovarus, two equinovalgus, one heel varus, four combination of these deformities. All patients had associated proximal pathology. These included seven shortening (six tibia, one femur), eight deformities (seven tibia, one femur), eight non-union (five infected non-union), (14) combination of these pathologies. All required simultaneous correction.
Method: We studied the aetiology, pathophysiology of injury, clinical and radiological evaluation, and the outcome of treatment. The patients’ mean age was 37 years (range 16–56). Thirty deformities were sequelae of severe lower limb trauma; the others were due to neurological, congenital and iatrogenic causes. In all patients, conventional surgical methods had failed to achieve correction and many of them were considered for amputation. We describe the operative strategy and technique.
Results: The aim of foot and ankle surgery was correction of deformity and contractures in 28 instances, correction of deformity and ankle fusion in 11 instances, and correction of deformity and ankle distraction in two instances. Thirty patients underwent bony corrective osteotomies, nine foot and ankle, 20 tibia and fibulae, one femur. For each patient, specific treatment goals were delineated that were realistically achievable. There were (78%) good to excellent results, (14%) fair result and (8%) poor results, which resulted in below knee amputation.
Conclusion: Circular external fixation offers a versatile and effective method of treatment of a variety of complex foot and ankle deformities. If foot and leg deformities coexist consider simultaneous correction. Fusion should be considered where muscular imbalance exists.
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.
At least one of the authors is receiving or has received material benefits or support from a commercial source.
