| Objective:Through the application of Ilizarov external fixation technology slow distraction of minimally invasive treatment of traumatic clubfoot deformity, through the evaluation of postoperative foot activities without pain and discomfort, appearance recovery, foot weight-bearing position, ankle joint movable degree etc., to judge the effect of treatment. Discussion of Ilizarov external fixation and limited osteotomy and comprehensive treatment of the advantages, to type, limited osteotomy principle, preoperative and postoperative note.Methods:From2009January to2013March, using Ilizarov external fixation technology slow distraction of minimally invasive treatment of traumatic clubfoot patients30cases30feet, of which22cases were male,8female; aged5to47years old, average20years old. The right foot in21cases, the left foot in9cases. All abnormalities were result from trauma. Open fracture of tibia and fibula and (or) soft tissue injury in14cases;2cases of osteofascial compartment syndrome;2cases of common peroneal nerve injury; fracture of foot and ankle (or) soft tissue injury in12cases. In the30cases with30feet were with Ilizarov external fixator and during the same period the Achilles tendon lengthening. The15foot simultaneous calcaneocuboid, talonavicular joint limited osteotomy and fusion,5foot simultaneous with distance, calcaneocuboid, talonavicular joint limited osteotomy and fusion,13foot simultaneous plantar fasciotomy,4foot simultaneous muscle strength balance foot tendon transfer. About7days after the adjustment of external fixator, the foot gradually in the neutral position after the cessation of adjustable bracket. Tighten all the screws, let the patient to walk with crutches exercise. Simple patients with soft tissue operation, after January, as the case may be the removal of external fixation; bone operation for patients in need of healing, depending on the circumstances, the demolition (pulling process at0.5-1mm/D rate, daily4times). Drafting in the rectification process should actively carry out foot weight-bearing walking and corresponding functional exercise.Results:After operation,30cases were followed up, the mean follow-up time was15months (3～28months). According to the evaluation of Green and Lloyd-Roberts clubfoot curative effect standard.The results were excellent in25cases, good in5cases, poor in0cases. Good appearance, weight, foot joint activities, walking without pain and discomfort. This group was4cases discharged after needle crossing a mild infection, control of inflammation after treatment. No skin necrosis, vascular and nerve injury and other complications.Conclusion:Ilizarov external fixator slow draft of minimally invasive treatment of traumatic talipes equinovarus deformity, with small trauma, simple and convenient operation, a slow, sustained orthopedic, does not affect the development of foot, treatment during the early weight-bearing, walking, and functional exercise. For obvious deformity bony clubfoot deformity of the limited osteotomy combined with Ilizarov external fixator slow draft can be further shortened the time correction, reduces the risk of equinovarus deformity recurrence after operation. |
