Background
About 20% of operated clubfeet develop recurrence or show a marked residual deformity. The failure of concentric reduction at the time of initial surgery has to be considered as a main factor. Residual forefoot adduction and supination are the most common persistent deformities. Methods of classification, assessment, and treatment of this problem were advanced over many years. Conventional management techniques tend to have many disadvantages including neurovascular injury, soft tissue problems, and a shortened foot.
Patients and methods
We present our experience in correction of 20 relapsed clubfeet deformities managed by gradual correction using Ilizarov frame without soft tissue release or bony procedures. The age at the time of operation ranged from 3 to 7 years with a mean of 4.4±1.31 years. The duration of use of fixators for correction ranged from 6 to 8 weeks with a mean of 7.09±0.37 weeks. This was followed by 6 weeks of leg cast. The patient was followed up with the use of custom-made shoes. The follow-up period ranged from 24 to 31 months, with a mean of 27.68±1.91 months.
Results
In all, 8 ft (40%) achieved excellent results, 6 ft (30%) achieved good results, 4 ft (20%) achieved fair results, and 2 ft (10%) achieved poor results. Complications were reported as pin tract infection in 6 ft, residual forefoot adduction in 4 ft, joint stiffness in 4 ft, toe flexion deformity in 2 ft, and radiological osteopenia in 2 ft.
Conclusion
The Ilizarov technique in relapsed complex foot deformity correction enables correction of individual components of the deformity at rates that may be tailored to achieve accurate three-dimensional control using an easy-to-handle, light, cheap, and simple frame.