Citation Information :
Malizos KN, Gougoulias NE, Dailiana ZH, Rigopoulos N, Moraitis T. Relapsed clubfoot correction with soft-tissue release and selective application of Ilizarov technique. 2008; 3 (3):109-117.
The Ilizarov technique is an alternative for the treatment of complex foot deformities in children. The authors retrospectively reviewed children with relapsed clubfoot deformity, treated with soft tissue procedures and additional correction with an Ilizarov frame. Twelve consecutive patients (13 feet) with relapsed clubfoot deformity after previous surgical correction were reviewed. Treatment included open releases. An Ilizarov frame was applied as an adjunct in seven patients (mean age of 7.8 years) with severe deformity where complete intraoperative correction was not achieved. Clinical and radiographic assessment was undertaken. The mean Laaveg–Ponseti score, for the 7 feet treated with the Ilizarov frame, was 85.1 after minimum 4 years follow-up. One recurrence of forefoot deformity required metatarsal osteotomies. Postoperative radiographic measurements revealed values that can be considered as normal. Complications included pin tract infections (12% of inserted wires). Flat-topped talus was observed in 3 feet. Deformity correction was possible when soft tissue procedures were combined with the use of Ilizarov technique, in order to support and gradually improve surgical correction.
Davidson RS (2003) Clubfoot salvage: a review of the past decade's contributions. J Pediatr Orthop 23:410-418
Ippolito E, Farsetti P, Caterini R, Tudisco C (2006) Long-term comparative results in patients with congenital clubfoot treated with two different protocols. J Bone Joint Surg Am 85A:1286- 1294
Dobbs MB, Nunley R, Schoenecker PL (2006) Long-term followup of patients with clubfeet treated with extended soft tissue release. J Bone Joint Surg Am 88A:986-996
Ilizarov GA (1989) The tension-stress effect on the genesis and growth of tissues. Part 1: the influence of stability of fixation and soft tissue preservation. Clin Orthop 238:249-281
Franke J, Grill F, Hein G, Simon M (1990) Correction of clubfoot relapse using Ilizarov's apparatus in children 8-15 years old. Arch Orthop Trauma Surg 110:33-37
Grant AD, Atar D, Lehman WB (1992) The Ilizarov technique in correction of complex foot deformities. Clin Orthop 280:94-103
Paley D (1993) The correction of complex foot deformities using Ilizarov's distraction osteotomies. Clin Orthop 293:97-111
Tetsworth KD, Paley D (1994) Accuracy of correction of complex lower extremity deformities by the Ilizarov method. Clin Orthop 301:102-110
Wallander H, Hansson G, Tjerstrom B (1996) Correction of persistent clubfoot deformities with the Ilizarov external fixator. Acta Orthop Scand 67:283-287
Bradish CF, Noor S (2000) The Ilizarov method in the management of relapsed clubfeet. J Bone Joint Surg Br 82B:387-391
Hosny GA (2002) Correction of foot deformities by the Ilizarov method without corrective osteotomies or soft tissue release. J Paediatr Orthop B 11:121-128
Gibbons CT, Montgomery RJ (2003) Management of foot and ankle conditions using Ilizarov technique. Current Orthopaedics 17:436-446
Barbary HE, Ghani HA, Hegazy M (2004) Correction of relapsed or neglected clubfoot using a simple Ilizarov frame. Int Orthop 28:183-186
Burns KJ, Sullivan R (2004) Correction of severe residual clubfoot deformity in adolescents with the Ilizarov technique. Foot Ankle Clin N Am 9:571-582
Ferreira RC, Costo MT, Frizzo MM, Filho FFF (2006) Correction of neglected clubfoot using the Ilizarov external fixator. Foot Ankle Int 27:266-273
Freedman JA, Watts H, Oisuka N (2006) The Ilizarov method for the treatment of resistant clubfoot: is it an effective solution? J Pediatr Orthop 26(4):432-437
Nakase T, Yasui N, Shimizu N, Yoshikawa H (2006) Tretament of relapsed idiopathic clubfoot y complete subtalar release combined with the Ilizarov method. J Foot Ankle Surg 45(5):337-341
Utukuri MM, Ramadrachan M, Hartley J, Hill RA (2006) Patientbased outcomes after Ilizarov surgery in resistant clubfeet. J Pediatr Orthop B 15(4):278-284
Ferreira RC, Costa MT, Frizzo GG, Santin RAL (2007) Correction of severe recurrent clubfoot using a simplified setting of the Ilizarov device. Foot Ankle Int 28:557-568
Prem H, Zenios M, Farrel R, Day JB (2007) Soft tissue Ilizarov correction of congenital talipes equinovarus, 5 to 10 years postsurgery. J Pediatr Orthop 27(2):220-224
Conti SF, Kirschner JS, van Sickle D (2001) Midfoot ostetomies. Foot Ankle Clin N Am 6(3):519-532
Laaveg SJ, Ponseti IV (1980) Long-term results of treatment of congenital club foot. J Bone Joint Surg Am 62:23-31
Fridman MW, de Almeida Fialho HS (2006) The role of radiographic measurements in the evaluation of congenital clubfoot surgical results. Skeletal Radiol 36(2):129-138
Turco VJ (1979) Resistant congenital clubfoot: one-stage posteromedial release with internal fixation: a follow-up report of a fifteen-year experience. J Bone Joint Surg Am 61:805-814
Hutchins PM, Foster BK, Paterson DC, Cole EA (1985) Longterm results of early surgical release in club feet. J Bone Joint Surg Br 67:791-799
Carroll NC (1997) Clubfoot: what have we learned in the last quarter century? J Pediatr Orthop 17:1-2
Atar D, Lehman WH, Grant AD, Strongwater AM (1992) Revision surgery in clubfeet. Clin Orthop 283:223-230
McKay DW (1983) New concept of an approach to clubfoot treatment—evaluation and results. J Pediatr Orthop 3:141-148
