1.Clubfoot Deformity Treatment with Ilizarov Apparatus in the Paediatric Population without Corrective Osteotomies and Soft Tissue Release: A Cross-Sectional Study
Aslani HS ; Athari MB ; Tavakoli-Darestani R ; Pourmojarab A ; Baroutkoub M ; Zamani M
Malaysian Orthopaedic Journal 2023;17(No.3):42-47
Introduction: Neglected Club Foot deformity is not an
uncommon limb anomaly encountered by orthopaedic
surgeons. Many treatment methods have been proposed.
Ilizarov apparatus is one of the techniques used to correct
this deformity.
Materials and methods: In this cross-sectional study 47
patients (56 feet) between the ages of 5 and 10 years with
clubfoot deformity were treated using the Ilizarov external
fixator. Age, sex, type of deformity, and radiographic
parameters were measured on foot radiographs. Also, the
American Orthopaedic Foot and Ankle Society (AOFAS)
score and the Dimeglio classification were recorded for each
patient before and after treatment.
Results: The treatment was unilateral in 38 patients and
bilateral in 9 patients. 39 patients (69.6%) were male, and 17
patients (30.4%) were female with a mean age of 7.86 ± 1.4
years. Plantar angles of ankle flexion and ankle flexion curve
increased from 20.12±6.52 and -16.51±8.36 to 25.89±6.44
and 6.19±6.42, respectively. There was also an improvement
in the talocalcaneal and tibiocalcaneal angles. Also, the angle
between the first metatarsus and the talus in the front and
side views improved (P<0.00). Additionally, the mean
AOFAS score and Dimeglio classification significantly
improved. Three cases were complicated with distal tibial
physeal separation that were treated with additional open
surgeries.
Conclusion: Ilizarov technique without osteotomies and soft
tissue release could be considered a less invasive and
successful method of treatment for neglected clubfoot
deformity in patient five to ten years old that are not good
candidate for Ponseti method.