Kocaoğlu Mehmet, Eralp Levent, Atalar Ata Can, Bilen F Erkal
Department of Orthopaedics and Traumatology, Istanbul University, Istanbul School of Medicine, Turkey.
J Foot Ankle Surg. 2002 Jan-Feb;41(1):30-9. doi: 10.1016/s1067-2516(02)80007-2.
There are many drawbacks to using conventional approaches to the treatment of complex foot deformities, like the increased risk of neurovascular injury, soft-tissue injury, and the shortening of the foot. An alternative approach that can eliminate these problems is the Ilizarov method. In the current study, a total of 23 deformed feet in 22 patients were treated using the Ilizarov method. The etiologic factors were burn contracture, poliomyelitis, neglected and relapsed clubfoot, trauma, gun shot injury, meningitis, and leg-length discrepancy (LLD). The average age of the patients was 18.2 (5-50) years. The mean duration of fixator application was 5.1 (2-14) months. We performed corrections without an osteotomy in nine feet and with an osteotomy in 14 feet. Additional bony corrective procedures included three tibial and one femoral osteotomies for lengthening and deformity correction, and one tibiotalar arthrodesis in five separate extremities. At the time of fixator removal, a plantigrade foot was achieved in 21 of the 23 feet by pressure mat analysis. Compared to preoperative status, gait was subjectively improved in all patients. Follow-up time from surgery averaged 25 months (13-38). Pin-tract problems were observed in all cases. Other complications were toe contractures in two feet, metatarsophalangeal subluxation from flexor tendon contractures in one foot, incomplete osteotomy in one foot, residual deformity in two feet, and recurrence of deformity in one foot. Our results indicate that the Ilizarov method is an effective alternative means of correcting complex foot deformities, especially in feet that previously have undergone surgery.
使用传统方法治疗复杂足部畸形存在许多缺点，如神经血管损伤、软组织损伤风险增加以及足部缩短。一种可以消除这些问题的替代方法是伊里扎洛夫方法。在本研究中，使用伊里扎洛夫方法治疗了22例患者的23只畸形足。病因包括烧伤挛缩、小儿麻痹症、 neglected和复发性马蹄内翻足、创伤、枪伤、脑膜炎以及腿长不等（LLD）。患者的平均年龄为18.2（5 - 50）岁。固定器应用的平均持续时间为5.1（2 - 14）个月。我们对9只足未进行截骨矫正，对14只足进行了截骨矫正。额外的骨性矫正手术包括3例胫骨和1例股骨截骨用于延长和畸形矫正，以及5个不同肢体各进行了1例胫距关节融合术。在拆除固定器时，通过压力垫分析，23只足中的21只实现了足底着地。与术前状态相比，所有患者的步态在主观上均有改善。手术的平均随访时间为25个月（13 - 38）。所有病例均观察到针道问题。其他并发症包括2只足出现趾挛缩，1只足因屈肌腱挛缩导致跖趾关节半脱位，1只足截骨不完全，2只足残留畸形，1只足畸形复发。我们的结果表明，伊里扎洛夫方法是矫正复杂足部畸形的一种有效替代方法，尤其是对于先前接受过手术的足部。
