Ilizarov TECHNOLOGY COMBINED WITH TARSAL V-SHAPE OSTEOTOMY FOR TREATMENT OF TRAUMATIC CLUBFOOT_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

DONGChanghong ¹ ,  JIANGShouhai ¹ , XUMingliang ¹ , HUJingnan ¹ , PENGAimin ² , ZHENGXuejian ³

1. Department of Orthopaedics, Renci Hospital, Xuzhou Jiangsu, 221004, P. R. China;
2. Beijing Bone External Fixation Technology Institute;
3. Department of Plastic Surgery, Beijing Chui Yang Liu Hospital;

Corresponding author：

JIANGShouhai, Email: dchh0303@126.com

Keywords：

Clubfoot; Ilizarov technology; Tarsal V-shape osteotomy

DOI：

10.7507/1002-1892.20150316

Video：

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Objective To discuss the effectiveness of Ilizarov technology combined with tarsal V-shape osteotomy for the treatment of traumatic clubfoot. Methods Between August 2011 and August 2014, 14 patients with traumatic clubfoot were treated. There were 10 males and 4 females, aged 13 to 61 years (mean, 31 years). Of 14 cases, 11 had open fractures of the tibia and ankle, and 3 had closed fracture of the ankle joint. The interval from trauma to operation was 7-78 months (mean, 36 months). The plantar flexion of the ankle was 44-89° (mean, 57°). After invasive foot soft tissue release and tarsal V-shape osteotomy, the Ilizarov external fixator with elastic stretching rod was used. At 5-12 weeks after operation, the neutral position of the ankle joint was restored. Then the neutral position of the ankle joint was maintained for 8 to 12 weeks. After removal of external fixator, protective walking brace was used for 8 to 12 weeks. Results Infection occurred in 9 cases, and was cured after symptomatic treatment. The patients were followed up 10-36 months (mean, 15 months). After treatment, 14 patients had normal appearance of the ankle joint, and X-ray films showed normal structure of the ankle. The ankle dorsal extension was 10° in 9 patients, who had normal walking function; it was 5° in 4 patients, who could walk; in 1 case of neutral position, the foot had no function of up and down stairs. One case had pain during correction because of poor tolerance, and delay traction was given, the function was recovered to normal after active rehabilitation training. According to the International Clubfoot Study Group (ICFSG) score standard, the results were excellent in 9 cases, good in 4 cases, and fair in 1 case; the excellent and good rate was 92.9% at last follow-up. Conclusion Ilizarov external fixation combined with V-shape osteotomy is effective for the treatment of traumatic clubfoot, with the advantages of less trauma, reliable fixation, satisfactory correction of the deformity, and good function recovery of the ankle.

Citation： DONGChanghong, JIANGShouhai, XUMingliang, HUJingnan, PENGAimin, ZHENGXuejian. Ilizarov TECHNOLOGY COMBINED WITH TARSAL V-SHAPE OSTEOTOMY FOR TREATMENT OF TRAUMATIC CLUBFOOT. Chinese Journal of Reparative and Reconstructive Surgery, 2015, 29(12): 1474-1477. doi: 10.7507/1002-1892.20150316 Copy

1.	Paley D. The correction of complex foot defomities using Ilizarov's distraction osteotomies. Clin Orthop Relat Res, 1993, (293):97-111.
2.	秦泗河, 陈建文, 郑学建, 等. Ilizarov张力-应力法则结合三关节有限截骨术矫正成年人重度马蹄内翻足. 中华骨科杂志, 2004, 24(6):338-341.
3.	Ferreira RC, CostoMT, Frizzo GG, et al. Correction of neglected clubfoot using the Ilizarov extemal fixator. Foot Ankle Int, 2006, 27(4):266-273.
4.	Prem H, ZeniosM, Farrel R, et al. Soft tissue Ilizarov correction of congenital talipes equinovarus 5 to 10 years postsurgery. J Pediatr Orthop, 2007, 27(2):220-224.
5.	李浪, 黄奇, 高峰, 等. Ilizarov技术结合非融合理念矫治创伤后马蹄内翻足. 中国修复重建外科杂志, 2014, 28(7):823-827.
6.	赵巍, 任龙喜, 梁喜斌, 等. Ilizarov技术联合跟腱经皮多点松解术治疗僵硬型马蹄内翻足畸形的临床疗效. 中国矫形外科杂志, 2013, 21(23):2356-2361.
7.	彭爱民, 韩义连, 韩庆海, 等. 仿踝关节生理运动跟腱弹性牵伸器在小腿Ilizarov延长中的应用. 中国矫形外科杂志, 2012, 20(21):1939-1943.
8.	夏和桃. 实用骨外固定学. 北京:人民卫生出版社, 2013:156.
9.	秦泗河, 郭保逢, 任龙喜, 等. 有限矫形手术与Ilizarov技术治疗青少年先天性马蹄内翻足. 中国修复重建外科杂志, 2012, 26(1):31-35.
10.	秦泗河. Ilizarov技术骨科应用进展. 北京:人民军医出版社, 2014:486, 642.
11.	Malizos KN, Gougulias NE, Dailiana ZH, et al. Relapsed clubfoot correction with soft-tissue and selective application of Ilizarov technique. Strategies Trauma Limb Reconstr, 2008, 3(3):109-117.
12.	秦泗河, 桂鉴超, 梁晓军. 外固定与足踝重建. 北京:人民卫生出版社, 2015:452.
13.	邓京城, 潘少川. 伊氏外固定器治疗小儿马蹄内翻足. 中华小儿外科杂志, 1995, 12(6):326-328.
14.	Calhoun JH, Evans EB, Herndon DH. Techniques for the mangement of burn contractures with the Ilizarov fixator. Clin Orthop Relat Res, 1992, (280):117-124.
15.	Ilizarov GA. Clinical application of the tension stress effect for limblengthening. Clin Orthop Relat Res, 1990, (250):8-26.
16.	Barker KL, Lamb SE, Simpson AH. Functional recovery in patients with nonunion treated with the Ilizarov technique. J Bone Joint Surg (Br), 2004, 86(1):81-85.
17.	陈建文, 秦泗河. Ilizarov技术矫治马蹄足畸形的临床应用进展. 中国矫形外科杂志, 2010, 18(1):53-57.

1. Paley D. The correction of complex foot defomities using Ilizarov's distraction osteotomies. Clin Orthop Relat Res, 1993, (293):97-111.
2. 秦泗河, 陈建文, 郑学建, 等. Ilizarov张力-应力法则结合三关节有限截骨术矫正成年人重度马蹄内翻足. 中华骨科杂志, 2004, 24(6):338-341.
3. Ferreira RC, CostoMT, Frizzo GG, et al. Correction of neglected clubfoot using the Ilizarov extemal fixator. Foot Ankle Int, 2006, 27(4):266-273.
4. Prem H, ZeniosM, Farrel R, et al. Soft tissue Ilizarov correction of congenital talipes equinovarus 5 to 10 years postsurgery. J Pediatr Orthop, 2007, 27(2):220-224.
5. 李浪, 黄奇, 高峰, 等. Ilizarov技术结合非融合理念矫治创伤后马蹄内翻足. 中国修复重建外科杂志, 2014, 28(7):823-827.
6. 赵巍, 任龙喜, 梁喜斌, 等. Ilizarov技术联合跟腱经皮多点松解术治疗僵硬型马蹄内翻足畸形的临床疗效. 中国矫形外科杂志, 2013, 21(23):2356-2361.
7. 彭爱民, 韩义连, 韩庆海, 等. 仿踝关节生理运动跟腱弹性牵伸器在小腿Ilizarov延长中的应用. 中国矫形外科杂志, 2012, 20(21):1939-1943.
8. 夏和桃. 实用骨外固定学. 北京:人民卫生出版社, 2013:156.
9. 秦泗河, 郭保逢, 任龙喜, 等. 有限矫形手术与Ilizarov技术治疗青少年先天性马蹄内翻足. 中国修复重建外科杂志, 2012, 26(1):31-35.
10. 秦泗河. Ilizarov技术骨科应用进展. 北京:人民军医出版社, 2014:486, 642.
11. Malizos KN, Gougulias NE, Dailiana ZH, et al. Relapsed clubfoot correction with soft-tissue and selective application of Ilizarov technique. Strategies Trauma Limb Reconstr, 2008, 3(3):109-117.
12. 秦泗河, 桂鉴超, 梁晓军. 外固定与足踝重建. 北京:人民卫生出版社, 2015:452.
13. 邓京城, 潘少川. 伊氏外固定器治疗小儿马蹄内翻足. 中华小儿外科杂志, 1995, 12(6):326-328.
14. Calhoun JH, Evans EB, Herndon DH. Techniques for the mangement of burn contractures with the Ilizarov fixator. Clin Orthop Relat Res, 1992, (280):117-124.
15. Ilizarov GA. Clinical application of the tension stress effect for limblengthening. Clin Orthop Relat Res, 1990, (250):8-26.
16. Barker KL, Lamb SE, Simpson AH. Functional recovery in patients with nonunion treated with the Ilizarov technique. J Bone Joint Surg (Br), 2004, 86(1):81-85.
17. 陈建文, 秦泗河. Ilizarov技术矫治马蹄足畸形的临床应用进展. 中国矫形外科杂志, 2010, 18(1):53-57.

Chinese Journal of Reparative and Reconstructive Surgery

Ilizarov TECHNOLOGY COMBINED WITH TARSAL V-SHAPE OSTEOTOMY FOR TREATMENT OF TRAUMATIC CLUBFOOT

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