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, 陳建文, 鄭學建, 等. Ilizarov張力-應力法則結合三關節有限截骨術矯正成年人重度馬蹄內翻足. 中華骨科雜志, 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, 黃奇, 高峰, 等. Ilizarov技術結合非融合理念矯治創傷后馬蹄內翻足. 中國修復重建外科雜志, 2014, 28(7):823-827.
6.	趙巍, 任龍喜, 梁喜斌, 等. Ilizarov技術聯合跟腱經皮多點松解術治療僵硬型馬蹄內翻足畸形的臨床療效. 中國矯形外科雜志, 2013, 21(23):2356-2361.
7.	彭愛民, 韓義連, 韓慶海, 等. 仿踝關節生理運動跟腱彈性牽伸器在小腿Ilizarov延長中的應用. 中國矯形外科雜志, 2012, 20(21):1939-1943.
8.	夏和桃. 實用骨外固定學. 北京:人民衛生出版社, 2013:156.
9.	秦泗河, 郭保逢, 任龍喜, 等. 有限矯形手術與Ilizarov技術治療青少年先天性馬蹄內翻足. 中國修復重建外科雜志, 2012, 26(1):31-35.
10.	秦泗河. Ilizarov技術骨科應用進展. 北京:人民軍醫出版社, 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, 桂鑒超, 梁曉軍. 外固定與足踝重建. 北京:人民衛生出版社, 2015:452.
13.	鄧京城, 潘少川. 伊氏外固定器治療小兒馬蹄內翻足. 中華小兒外科雜志, 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.	陳建文, 秦泗河. Ilizarov技術矯治馬蹄足畸形的臨床應用進展. 中國矯形外科雜志, 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, 陳建文, 鄭學建, 等. Ilizarov張力-應力法則結合三關節有限截骨術矯正成年人重度馬蹄內翻足. 中華骨科雜志, 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, 黃奇, 高峰, 等. Ilizarov技術結合非融合理念矯治創傷后馬蹄內翻足. 中國修復重建外科雜志, 2014, 28(7):823-827.
6. 趙巍, 任龍喜, 梁喜斌, 等. Ilizarov技術聯合跟腱經皮多點松解術治療僵硬型馬蹄內翻足畸形的臨床療效. 中國矯形外科雜志, 2013, 21(23):2356-2361.
7. 彭愛民, 韓義連, 韓慶海, 等. 仿踝關節生理運動跟腱彈性牽伸器在小腿Ilizarov延長中的應用. 中國矯形外科雜志, 2012, 20(21):1939-1943.
8. 夏和桃. 實用骨外固定學. 北京:人民衛生出版社, 2013:156.
9. 秦泗河, 郭保逢, 任龍喜, 等. 有限矯形手術與Ilizarov技術治療青少年先天性馬蹄內翻足. 中國修復重建外科雜志, 2012, 26(1):31-35.
10. 秦泗河. Ilizarov技術骨科應用進展. 北京:人民軍醫出版社, 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, 桂鑒超, 梁曉軍. 外固定與足踝重建. 北京:人民衛生出版社, 2015:452.
13. 鄧京城, 潘少川. 伊氏外固定器治療小兒馬蹄內翻足. 中華小兒外科雜志, 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. 陳建文, 秦泗河. Ilizarov技術矯治馬蹄足畸形的臨床應用進展. 中國矯形外科雜志, 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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