The Ilizarov method for the treatment of resistant clubfoot: Is it an effective solution?

Jason A. Freedman, Hugh Watts, Norman Y. Otsuka

Research output: Contribution to journalArticle

37 Citations (Scopus)

Abstract

The resistant clubfoot deformity presents a significant challenge. Several corrective procedures have been described, with the goal to provide a pain-free, plantigrade foot. The Ilizarov method of external fixation and gradual distraction has been reported as an alternative to conventional techniques. Previous reviews have concluded that this method can provide satisfactory correction and outcome. This study presents a review of 21 resistant clubfeet in 17 patients, who had undergone previous surgery, treated with Ilizarov external fixation and gradual distraction by 1 of 2 surgeons. Outcome measures were graded based on function and presence of residual deformity: (a) excellent (painless, plantigrade foot, with no functional limitations); (b) good (plantigrade foot in a patient able to ambulate long distances with mild pain; (c) fair (mild residual deformity, required bracing, and/or had some functional limitations but an active life); and (d) poor (significant residual deformity, pain, and activity limitations). Radiographic measures of the talocalcaneal and talo-first metatarsal angles were compared preoperatively and postoperatively. At an average follow-up of 6.64 years (range, 2.25-10.50 years), 9.5% (2) achieved an excellent result; 4.8% (1), good; 33.3% (7), fair; and 52.4% (11), poor. All 11 of the feet graded poor required revision surgery at an average of 5.63 years postoperatively (range, 2.67-10.2 years). Only the talo-first metatarsal angle displayed a clinically and statistically significant correction. We conclude that the Ilizarov method for treatment of resistant clubfoot deformities results in poor outcome associated with residual or recurrent deformity, often requiring revision surgery.

Original languageEnglish (US)
Pages (from-to)432-437
Number of pages6
JournalJournal of Pediatric Orthopaedics
Volume26
Issue number4
DOIs
StatePublished - Jul 2006
Externally publishedYes

Fingerprint

Ilizarov Technique
Clubfoot
Foot
Metatarsal Bones
Reoperation
Pain
Therapeutics
Outcome Assessment (Health Care)

Keywords

  • Clubfoot
  • Ilizarov
  • Outcome
  • Surgery

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Surgery
  • Orthopedics and Sports Medicine

Cite this

The Ilizarov method for the treatment of resistant clubfoot : Is it an effective solution? / Freedman, Jason A.; Watts, Hugh; Otsuka, Norman Y.

In: Journal of Pediatric Orthopaedics, Vol. 26, No. 4, 07.2006, p. 432-437.

Research output: Contribution to journalArticle

Freedman, Jason A. ; Watts, Hugh ; Otsuka, Norman Y. / The Ilizarov method for the treatment of resistant clubfoot : Is it an effective solution?. In: Journal of Pediatric Orthopaedics. 2006 ; Vol. 26, No. 4. pp. 432-437.
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