title: Recurrence rates of burn contracture ankle equinus and other foot deformities in children treated with Ilizarov fixation.
abstract: The purpose of this study was to determine recurrence rates of pediatric foot and ankle burn deformities treated with the Ilizarov method. A total of 19 patients with 29 foot and ankle deformities were studied. The most common deformity treated was equinus (23). Rocker-bottom and cavus foot deformities were each treated three times. The average age of the patient at the time of the burn injury was 3.2 years, and the average age at the time of fixation was 9.4 years. Equinus contractures averaged -34 degrees (34 degrees of plantarflexion) before surgery and +7 degrees (7 degrees of dorsiflexion) after treatment with the Ilizarov fixator. The recurrence rate for all 29 ankles and feet was 69% (20/29). The recurrence rate for equinus contractures was 74% (17/23). The average time to recurrence was 17.3 months. Only short-term follow-up was available on four of the six feet and ankles that did not recur. Deformity correction in burned feet and ankles is difficult to obtain by any means. The authors recommend using the Ilizarov method to obtain correction of moderate to severe foot and ankle deformities in pediatric burn patients, but the correction obtained is not stable and deformity will likely recur. Parents and patients should anticipate adjunctive nonoperative and operative procedures to keep their feet plantigrade as they grow. In young children, the possibility of having additional surgeries, including repeat Ilizarov procedures, should be discussed. Even older children should expect additional surgeries to prevent recurrent deformities.
authors.affiliation: Department of Orthopaedics and Rehabilitation, University of Texas Medical Branch, Galveston, Texas 77555-0353, USA. kdcarmic@utmb.edu
authors.forename: Kelly D
authors.initials: KD
authors.lastname: Carmichael
authors.forename: Seth C
authors.initials: SC
authors.lastname: Maxwell
authors.forename: Jason H
authors.initials: JH
authors.lastname: Calhoun
mesh_terms: D000293:Adolescent; D016512:Ankle Injuries / Q000150:complications* / Q000503:physiopathology / Q000601:surgery; D000843:Ankle Joint / Q000503:physiopathology; D002056:Burns / Q000150:complications* / Q000601:surgery; D002648:Child; D002675:Child, Preschool; D003286:Contracture / Q000453:epidemiology* / Q000209:etiology / Q000601:surgery; D004863:Equinus Deformity / Q000453:epidemiology* / Q000209:etiology / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D005531:Foot Deformities, Acquired / Q000601:surgery; D006801:Humans; D018889:Ilizarov Technique; D015994:Incidence; D007223:Infant; D008297:Male; D016059:Range of Motion, Articular; D012008:Recurrence; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome