THE ILIZAROV EXTERNAL FIXATION USED TO CO RRECT SEVERE FOOT DEFORMITIES

Material and methods 38 feet in 36 patients who underwent a progressiv e foot correction without osteotomies, with an Ilizarov frame have bee n reviewed. There were 23 equinovarus, 2 equinovalgus, 13 equinus defo rmities. In 20 patients, the deformity had relapsed after one to four previous operations. The mean follow-up was 22 (12-35) months. The mea n age was 17 years (6-68). There were 15 females and 21 males. Results All but 4 patients were satisfied with the result, although 15 still had pain during daily activities. The shape of the feet was distinctly improved in all patients, although residual equinus was found in 6 pa tients, residual varus in 2 and forefoot problems in 6. Pintract infec tions were encountered in half of the patients, all settled with local treatment, adjustement of the tension of the wires and antibiotics. T hree specific complications were encountered : talus subluxations (7), toe contractures (6), relapse of equinus (4). Discussion Few alternat ives are available to correct severe foot deformities. Soft tissue rel eases and/or wedge osteotomies are technically demanding, cause shorte ning of the foot, correct only one predominant component, are contrain dicated in patients with infections or a poor vascular or skin conditi on. Progressive correction by the Ilizarov method is a valuable altern ative, although we would like to stress the importance of some details in order to avoid the specific complications. Progressive correction of foot deformities by the Ilizarov frame is demanding for patient and surgeon. It should be reserved for the indications mentioned earlier and also for foot deformities combined with shortening or axial deviat ions.