Correction of adult foot deformities by ilizarov ring fixator

ABSTRACT

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