Novel external mini-frame for congenital talipes equinovarus in infants / 中国组织工程研究

ABSTRACT

BACKGROUND: Recently,Illizarov external frame is commonly used to treat adult talipes equinovarus.However,its application is limited in infant and child due to amount of components,large volume and heavy weight. OBJECTIVE: A new three-dimensional external mini-frame was designed to observe its therapentical effects for congenital talipes equinovarus in infants. DESIGN,TIME AND SETTING: Retraspectively analysis of the therapentical effects of the three-dimensional external mini-frame for congenital talipes equinovarus in infants at the Department of Pediatric Orthopedics,Third Hospital of Hebei Medical University between January 2004 and June 2007. PARTICIPANTS: 106 infants (130 feet) with congenital talipes equinovarus,76 males and 30 females aged 1.6 years (range 0.5-3 years),including 80 left feet and 50 right feet,24 cases bilateral feet and 82 cases unilateral feet. Eighty-one cases underwent orthosis or cost treatment but were not cured; 10 cases underwent surgery in other hospitals but all failed,the other cases were not given any treatment. The new three-dimensional external mini-frame was designed by the authors and produced by Hebei Hengshui Kangda. METHODS: According to the age,degree of deformity,being operated or not and pathological changeS of the foot,different treatment methods were applied Corrcetion and fixation of the foot directly with the new external mini-frame; Limited soft tissue release,followed by corrcetion and fixation of the foot with the mini-frame; Corrcetion and fixation of the foot with the mini-frame after more soft tissue realse on interior posterior foot; Corrcetion and fixation of the foot with the mini-frame after soft tissue release,tendon transfer and restore of muscle force balance. The postoperative external fixation lasted for about 3 mouths. MAIN OUTCOME MEASURES: Evaluatoin of therapentical effects according to Garceau standards. RESULTS: All cases were followed up for 2.5 years (range 0.5-3.5 years). Eighty-six cases (94 feet) were excellent the foot looked near normal,the calcar pedis was erect,with plantigrade foot in walking,the range of the joint motion in foot was near normal. Seventeen cases (32 feet) were good the foot deformity improved obviously,but a light adduction was remained in the forefoot,with plantigrade foot in walking,the range of joint motion in foot was good. Three cases (4 feet) were effective the forefoot adduct lightly,with lightly calcaneus varus,the motion of foot was limitted partly. CONCLUSION: The new 3D external mini-frame shows favorable effects for congenital talipes equinovarus in infants.