Treatment of severe equinus deformity associated with extensive scarring of the leg

Nine severe equinus deformities of the foot associated with extensive scarr ing of the leg and ankle were corrected using a hinged Ilizarov apparatus a nd free-tissue transfer. The average duration of followup was 38 months (ra nge, 28-54 months). Free tissue transfer was done in all patients; a parasc apular flap was used in seven patients, and a groin flap was used in two pa tients. The results were evaluated using two objective criteria and one sub jective assessment: the degree of active dorsiflexion, the range of active movement of the ankle, and daily activities. For active dorsiflexion of the ankle and activities, the results were good in seven patients and fair in two patients. For range of active motion of the ankle, the results were goo d in six patients and fair in two patients. One patient with ankle arthrode sis was excluded. This study showed that severe equinus deformities associa ted with extensive scarring of the leg and ankle can be corrected effective ly with heel cord lengthening, free-tissue transfer, and a hinged Ilizarov technique.