Long-term outcome after Ilizarov corrective fixation for severe foot deformity

Purpose of the study Much work has focused on the short-term outcome after external fixation with the Ilizarov apparatus for treatment of severe recur rent or neglected foot deformity. No series has provided sufficient follow- up to allow an analysis of long-term stabilization. Material and methods We reviewed a series of 17 patients (21 feet) treated with the Ilizarov apparatus between 1988 and 1998 and reexamined after a me an 6-year follow-up. We assessed the risk of degradation of the initial res ult and quantified the need for secondary arthrodesis surgery. This series included 18 congenital clubfeet and 3 cases of acquired talipes equinus. Me an patient age was 15 years. Results Pain, morphology, weight bearing attitude and quality of shoe fit w ere assessed. Results at treatment end were very good in 16 cases, good in 4 and poor in 1. Two early recurrences required arthrodesis. At last follow -up, results were very good in 17 cases, good in 3, and poor in 1 (late rec urrence with arthrogryposis). Discussion With 3 recurrences among 21 cases, results were maintained well over time in this series. Most of the recurre nces were observed during the first year and never completely reproduced th e initial deformation. In 2 out of 3 cases, the recurrence occurred on a se condary talipes equinovarus. Age was not a risk factor (only 2 feet have no t reached maturity to date). The lack of over-correction at treatment end i s a factor predictive of poor outcome. Conclusion Long-term outcome demonstrated the stability of the results and the absence of severe complications and foot shortening, emphasizing the im portant contribution of Ilizarov fixation for severe foot deformity.