Surgical treatment of neglected clubfoot using external fixator

ABSTRACT The definition of neglected clubfoot (NC) includes a variable range of complex deformities of the foot that are refractory to conventional treatments or are treated inappropriately. Several etiologies may be related to this. The Ilizarov method has become established as a tool for treating...

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Bibliographic Details
Main Authors: Rodrigo Mota Pacheco Fernandes, Maurilio Darcy dos Santos Mendes, Renato Amorim, Marcus Aurélio Preti, Marcelo Back Sternick, Guilherme Pelosini Gaiarsa
Format: Article
Language:English
Published: Sociedade Brasileira de Ortopedia e Traumatologia
Series:Revista Brasileira de Ortopedia
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Online Access:http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0102-36162016000500501&lng=en&tlng=en
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Summary:ABSTRACT The definition of neglected clubfoot (NC) includes a variable range of complex deformities of the foot that are refractory to conventional treatments or are treated inappropriately. Several etiologies may be related to this. The Ilizarov method has become established as a tool for treating these deformities. It minimizes soft-tissue damage through gradual correction of the deformity, with a high success rate in relation to achieving a plantigrade foot, with low incidence of recurrence. The indications for treatment include severe rigid deformities (Dimeglio III and IV), or adverse skin conditions. Careful clinical and radiological examination is fundamental for proper planning and installation of the external fixator. The techniques used include selection of external fixation assemblies, which can be closed when there is a connection between the leg, hindfoot and forefoot. This closed assembly may or may not be constricted, according to whether hinges are provided or whether use of the natural anatomical hinges during correction of the deformity is envisaged. An open assembly makes it possible to add flexibility to the foot through histogenesis, while allowing closed corrections of greater precision later on. Hexapod fixators are an innovation with high potential for accuracy in correcting deformities. Procedures associated with external fixation include soft-tissue release and bone procedures. These procedures enable corrections that are more anatomical, for different degrees of severity and stiffness of deformity. It can be concluded from analyzing this case series that treatment of neglected clubfoot using an external fixator has a high rate of good and excellent results, with low frequency of complications.
ISSN:1982-4378