Tecimel Osman, Öçgüder Ali, Doğan Metin, Uğurlu Mahmut, Bozkurt Murat, Ateşalp Sabri
Department of Orthopedics and Traumatology, Atatürk Training and Research Hospital, Ankara, Turkey.
Eklem Hastalik Cerrahisi. 2013;24(2):72-6. doi: 10.5606/ehc.2013.17.
This study aims to evaluate the outcomes of the Ilizarov external fixator for the correction of complex foot deformities.
Between January 2000 and September 2005, 29 feet of 25 patients (18 males, 7 females; mean age 13.7 years; range 5 to 24 years) who were applied Ilizarov external fixators due to complex foot deformities in our clinic were prospectively analyzed. Four patients had bilateral foot deformity. The distribution of the deformities was as follows: hindfoot inversion (calcaneovarus) in 29, forefoot equines (cavus) in 29, forefoot adductus in 28, forefoot and hindfoot supination in 27 and forefoot and hindfoot pronation in one foot. The mean length of hospital stay was 9.4 weeks (range, 6 to 18 weeks). Osteotomy was required in nine patients with ages ranging from 13 to 24. Middle subtalar osteotomy was applied on six patients, while three patients received subtalar osteotomy. In three patients, release was provided by removal of incision scar tissue. The mean follow-up was 48 months (range, 16-65 months).
The mean treatment period was 21.6 weeks (range, 18-31 weeks). All patients walked better following treatment. According to Paley's criteria, 27 feet were evaluated as plantigrade (flat) and two as non-plantigrade (non-flat). Two patients suffered from pain. The success rate of the treatment was 86.2%.
Ilizarov method appears to be an efficient approach thanks to the three dimensional characteristic of the foot and fixator in the correction of complicated foot deformities.
本研究旨在评估伊利扎洛夫外固定器矫正复杂足部畸形的效果。
2000年1月至2005年9月期间，对我院因复杂足部畸形应用伊利扎洛夫外固定器的25例患者（18例男性，7例女性；平均年龄13.7岁；年龄范围5至24岁）的29只脚进行前瞻性分析。4例患者为双侧足部畸形。畸形分布如下：29例后足内翻（跟骨内翻），29例前足马蹄足（高弓足），28例前足内收，27例前足和后足旋后，1只脚前足和后足旋前。平均住院时间为9.4周（范围6至18周）。9例年龄在13至24岁的患者需要进行截骨术。6例患者采用距下关节中部截骨术，3例患者接受距下关节截骨术。3例患者通过切除切口瘢痕组织进行松解。平均随访时间为48个月（范围16 - 65个月）。
平均治疗时间为21.6周（范围18至31周）。所有患者治疗后行走情况均有改善。根据佩利标准，27只脚评估为足底负重（扁平），2只为非足底负重（非扁平）。2例患者出现疼痛。治疗成功率为86.2%。
由于足部和固定器的三维特性，伊利扎洛夫方法在矫正复杂足部畸形方面似乎是一种有效的方法。
