ABSTRACT
We evaluated the results following the use of the Volkov-Oganesyan-Povarov hinged distraction apparatus to correct equinocavovarus deformity of the foot in sixty-five adults (eighty-three feet). The deformity was secondary to ischemic and neuropathic changes after trauma to the foot and ankle, poliomyelitis, Charcot-Marie-Tooth disease, or untreated clubfoot. The deformity often was associated with severe neurotrophic changes, extensive scarring of the skin, callosities, or osteomyelitis of the foot, all of which usually preclude operative reconstruction. The average age of the patients was twenty-six years (range, sixteen to fifty-six years). The average duration of follow-up was ten years (range, three to nineteen years). The duration of distraction was three to thirteen weeks, and the apparatus usually was kept in place for an additional two months after the desired position of correction had been achieved. The patient then wore a plaster cast for an average of eight weeks and custom-molded shoe-inserts for at least one year. A plantigrade foot was obtained with this external transosseous distraction device. Eight patients had inflammation of pin tracks, which was treated with local injection of antibiotics into the soft tissues and application of bandages soaked in antibiotics to the area around the pin sites. The pins were removed from five of the eight patients, and the apparatus was removed from three additional patients because of osteomyelitis. The results were classified as good in fifty-nine feet, satisfactory in twenty, and unsatisfactory in four. In the four feet (three patients) with an unsatisfactory result, a good result was obtained after an arthrodesis was done.
Subject(s)
Bone Lengthening/instrumentation , Foot Deformities, Acquired/surgery , Adolescent , Adult , Anti-Bacterial Agents/therapeutic use , Bone Lengthening/adverse effects , Bone Nails/adverse effects , Callosities/etiology , Casts, Surgical , Charcot-Marie-Tooth Disease/complications , Cicatrix/etiology , Clubfoot/complications , Dermatitis/drug therapy , Dermatitis/etiology , Equipment Design , External Fixators/adverse effects , Female , Follow-Up Studies , Foot Deformities, Acquired/etiology , Foot Diseases/etiology , Foot Injuries/complications , Humans , Male , Middle Aged , Orthotic Devices , Osteitis/drug therapy , Osteitis/etiology , Osteomyelitis/etiology , Poliomyelitis/complicationsABSTRACT
By means of angiography, made in 20 patients with rigidity of the first toes due to osteoarthrosis, there have been revealed chronic deficiency of blood circulation in the foot tissues, especially in its antero-internal section. Blood circulation deficiency is due either to the congenital anomaly of the foot vessels or to the consequences of their traumatic injuries. Blood supply deficiency results in degenerative-dystrophic changes of the first metatarsophalangeal articulations with development of their rigidity, aggravated by post-ischemic contracture of the foot muscles.
Subject(s)
Foot/blood supply , Hallux , Osteoarthritis , Adult , Angiography , Female , Foot/diagnostic imaging , Humans , Male , Middle Aged , Osteoarthritis/diagnostic imagingABSTRACT
In 56 patients (70 feet) with talipes equinocavovarus, various components of deformity were surgically corrected in multiple stages with the aid of a hinged-distraction apparatus and concurrent training and rehabilitation of motion in the ankle joint. Good results were obtained in 53 feet, satisfactory results in 13 feet, and unsatisfactory results in four feet. The complications brought on by apparatus-assisted therapy of talipes equinocavovarus deformities require additional treatment but do not depreciate the method.
Subject(s)
Clubfoot/surgery , External Fixators , Adolescent , Adult , Charcot-Marie-Tooth Disease/complications , Clubfoot/etiology , Clubfoot/rehabilitation , Female , Follow-Up Studies , Foot Deformities, Acquired/rehabilitation , Foot Deformities, Acquired/surgery , Humans , Male , Poliomyelitis/complicationsABSTRACT
The treatment of severe aggravated forms of equino-excavato-varus deformation of the feet of various etiology is rather difficult because the resections performed to eliminate the deformation require the removal of large quantities of the bone tissue and are traumatic, and when accompanied by neurotrophic disturbances they are usually contraindicated. At the Central Institute of Traumatology and Orthopaedics 65 patients with acutely pronounced feet deformations have been treated with Volkov-Organesian-Povarov distraction apparatuses. In 34 patients the deformation was accompanied by various neurotrophic disturbances. The results were good in 61 feet, satisfactory in 18 feet and bad in 4 feet. The experiment has demonstrated the efficacy of apparatus treatment, especially in the cases of aggravated forms of feet deformations, where this method often is the only one available.
