THE CORRECTION OF COMPLEX FOOT DEFORMITIES USING ILIZAROV DISTRACTIONOSTEOTOMIES

Twenty-five very complex foot deformities were treated by Ilizarov dis traction osteotomies. The osteotomy types included supramalleolar, U, V, posterior calcaneal, talocalcaneal neck, midfoot, and metatarsal os teotomies. In addition, the leg was lengthened and widened in most cas es. The mean treatment time was 6.4 months. There were 20 minor or maj or complications related to the foot osteotomies in 18 feet, including deep pin-tract infection in three, failure of osteotomy separation in nine, acute postoperative tarsal tunnel syndrome in two, toe contract ures in three, wire breakage or cutout in two, and buckle fracture in one. Nineteen secondary procedures were required in 13 patients to tre at these complications. The final result was a plantigrade foot in 22 in late follow-up evaluation. The three nonplantigrade feet were attri butable to unrecognized heel varus in one, ball and socket ankle joint in one, and partial growth arrest progressive deformity in one. Gait was improved in all cases. Pain was eliminated in all but two patients . Based on these criteria, the results were judged to be satisfactory in 22 and unsatisfactory in three. The Ilizarov method can successfull y correct complex foot deformities despite complications.