Window procedure versus turco procedure for treatment of talipes equino varus

To compare the results of Window procedure and Turco procedure [extended postero-medical release] for the treatment of Congenital Tilopes Equino Varus [CTEV]. Comparative study conducted from 1st June to 30th May 2005. Orthodopaedic unit II, Dow University of Health Sciences and Civil Hospital, Karachi. Sixty patients with mild to moderate CTEV according to the two groups i.e. W-Group [n=30] who underwent the Window procedure and T-Group [n=30] who were operated by the Turco technique. Amongst the 60 patients, 37 [61.75] were male and 23 [38,3%] female, with ages varying from 6-18 months. The average age was 9.5 months in W-Group and 9.6 months in the T-Group. The mean operating times was 12-16 minutes in the W-Group, while it was 40-45 minutes in the T-Group. Complications were seen in 13 cases in the T-Group and only two cases in the W-Group, while recurrence occurred in four cases in the Truco and only one case in the Window Group. Good results were seen in 905 of the W-Group and 60% of the t-Group. We conclude that the Window and Turco procedures are comparable operations for CTEV. However, Window procedure is better due to fewer complications, shorter operating time, lesser blood loss, decreased recurrence rate, less fibrosis and less stiffness of the ankle and knee joints

Correction of adult foot deformities by ilizarov ring fixator

To evaluate the efficacy of Ilizarov ring fixator in treating adult Foot Deformities. Descriptive Study from May 2003 to Dec. 2005. Orthopaedics Unit II at Civil Hospital, Karachi. Fourteen patients, three females and eleven males, were treated with the Ilizarov ring fixator. The ages of the patients ranged from 14 to 55 years [mean 19.4 years]. The deformities included were post-polio residual deformities, neglected and relapsed club feet, rocker bottom deformity, post-burn contractures, and neurotropic feet with myelomeningocele, post-traumatic and leg length discrepancy. The correction of the deformities was carried out with osteotomy in 13 feet and without osteotomy in one foot. The osteotomies used included triple arthrodesis in eight feet, U-Osteotomy in two feet, V-Osteotomy in two feet and supra-malleolar osteotomy in one patient. Tibial lengthening was done simultaneously in two patients. Ankle arthrodesis was done in one patient. Ilizarov ring fixator was applied for a total duration of 10 to 24 weeks [mean 16 weeks]. The mean post-operative follow-up was 18 months [range 12-26 months]. Plantigrade foot was achieved in all the cases at the time of Ilizarov ring fixator removal, and the gait improved. All the patients were satisfied with the outcome, except one in which the deformity recurred in a neurotropic foot. Pin tract injection was noticed in all the cases, from time to time. Ankle subluxation occured in one patient in which ankle arthrodesis was done. Incomplete osteotomy was noticed in one patient. Our study concludes that Ilizarov ring fixator allows simultaneous correction of severe deformities of the adult foot, with reduced risk of cutaneous and neuro vascular complications and avoiding the shortening of the foot