Department of Orthopaedic Surgery, Ain Shams Univ. Hospitals, Cairo, Egypt.
Foot Ankle Surg. 2011 Dec;17(4):287-93. doi: 10.1016/j.fas.2010.12.001. Epub 2011 Jan 13.
Complex foot deformity is a multi-planar foot deformity with many etiologic factors. Different corrective procedures using Ilizarov external fixation have been described which include, soft tissue release, V-osteotomy, multiple osteotomies and triple fusion.
In this study we compare the results of two groups of skeletally mature patients with complex foot deformity who were treated by two different protocols. The first group (27 patients, 29 feet) was treated by triple fusion fixed by Ilizarov external fixator until union. The second group (29 patients, 30 feet), was treated by triple fusion with initial fixation by Ilizarov external fixation until correction of the deformity was achieved clinically, and then the Ilizarov fixation was replaced by internal fixation using percutaneous screws. Both groups were compared as regard the surgical outcome and the incidence of complications.
There was statistically significant difference between the two groups regarding duration of external fixation and duration of casting with shorter duration in the group 2. Also there was statistically significant difference between both groups regarding pin tract infection with less incidence in group 2.
Early removal of Ilizarov external fixation after correction of the deformity and percutaneous internal fixation using 6.5 cannulated screws can shorten the duration of treatment and be more comfortable for the patient with a low risk of recurrence or infection.
复杂足畸形是一种多平面足畸形，有许多病因。已经描述了使用伊里扎洛夫外固定架进行的不同矫正手术，包括软组织松解、V 形截骨、多处截骨和三关节融合。
在这项研究中，我们比较了两组骨骼成熟的复杂足畸形患者，他们接受了两种不同方案的治疗。第一组（27 例患者，29 足）通过伊里扎洛夫外固定架固定的三关节融合术治疗，直至愈合。第二组（29 例患者，30 足）采用三关节融合术，初始固定采用伊里扎洛夫外固定架，直至临床矫正畸形，然后用经皮螺钉更换伊里扎洛夫固定架。比较两组的手术结果和并发症发生率。
两组患者在外部固定时间和石膏固定时间方面存在统计学显著差异，第二组的时间更短。两组患者在针道感染方面也存在统计学显著差异，第二组的发生率较低。
在矫正畸形后早期去除伊里扎洛夫外固定架，并采用 6.5 毫米空心螺钉进行经皮内固定，可以缩短治疗时间，提高患者舒适度，降低复发或感染的风险。
