title: Patient-based outcomes after Ilizarov surgery in resistant clubfeet.
abstract: We present the results of clinical evaluation and patient-based outcomes after Ilizarov surgery in resistant clubfeet (grade D clubfeet, Dimeglio-Bensahel system). This is a retrospective study of 26 resistant clubfeet in 23 children who were managed by the Ilizarov technique. The average age of the patients at the time of the operation was 9 years and the average follow-up period was 47 months. A calcaneal or mid-foot osteotomy followed by bony distraction was undertaken in nine feet and a soft-tissue distraction, with or without soft-tissue release, was undertaken in 17 feet. Clinical evaluation of the degree of correction of the deformity and functional evaluation, using patient-based questionnaires, were used in assessing the outcome in these patients. Patient-based outcomes give useful information about the functional status following surgery, complementing the objective assessment by the surgeon. Clinical evaluation revealed stiff, plantigrade feet in nine patients and a recurrent deformity after initial correction in the remaining 14 patients. The patient-based outcomes were good to excellent in 52% for satisfaction, 57% for cosmesis, 48% for walking and 73% for teasing (made fun of because of the shape of foot), showing that the functional results were better in these patients in spite of a poor surgical outcome.
authors.affiliation: Hospital for Sick Children, Great Ormond Street, London, UK.
authors.forename: Murali Mohan
authors.initials: MM
authors.lastname: Utukuri
authors.forename: Manoj
authors.initials: M
authors.lastname: Ramachandran
authors.forename: Jeanne
authors.initials: J
authors.lastname: Hartley
authors.forename: Robert A
authors.initials: RA
authors.lastname: Hill
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003025:Clubfoot / Q000000981:diagnostic imaging / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D007839:Functional Laterality; D006801:Humans; D018889:Ilizarov Technique; D008297:Male; D011859:Radiography; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome