[Ilizarov TECHNOLOGY COMBINED WITH TARSAL V-SHAPE OSTEOTOMY FOR TREATMENT OF TRAUMATIC CLUBFOOT].

OBJECTIVE: To discuss the effectiveness of Ilizarov technology combined with tarsal V-shape osteotomy for the treatment of traumatic clubfoot.

METHODS: Between August 2011 and August 2014, 14 patients with traumatic clubfoot were treated. There were 10 males and 4 females, aged 13 to 61 years (mean, 31 years). of 14 cases, 11 had open fractures of the tibia and ankle and 3 had closed fracture of the ankle joint. The interval from trauma to operation was 7-78 months (mean, 36 months). The plantar flexion of the ankle was 44-89° (mean, 57°). After invasive foot soft tissue release and tarsal V-shape osteotomy, the Ilizaroy external fixator with elastic stretching rod was used. At 5-12 weeks after operation, the neutra pos ofthe ankle joint was restored. Then the neutral position of the ankle joint was maintained for 8 to 12 weeks. After removal of external fixator, protective walking brace was used for 8 to 12 weeks.

RESULTS: Infection occurred in 9 cases, and was cured after symptomatic treatment. The patients were followed up 10-36 months (mean, 15 months). After treatment, 14 patients had normal appearance of the ankle joint, and X-ray films showed normal structure of the ankle. The ankle dorsal extension was 10° in 9 patients, who had normal walking function; it was 5° in 4 patients, who could walk; in 1 case of neutral position, the foot had no function of up and down stairs. One case had pain during correction because of poor tolerance, and delay traction was given, the function was recovered to normal after active rehabilitation training. According to the International Clubfoot Study Group (ICFSG) score standard, the results were excellent in 9 cases, good in 4 cases, and fair in 1 case; the excellent and good rate was 92.9% at last follow-up.

CONCLUSION: Ilizarov external fixation combined with V-shape osteotomy is effective for the treatment of traumatic clubfoot, with the advantages of less trauma, reliable fixation, satisfactory correction of the deformity, and good function recovery of the ankle.