Correction of complex equino cavo varus foot deformity in skeletally mature patients by Ilizarov external fixation versus staged external-internal fixation.
BACKGROUND
Complex foot deformity is a multi-planar foot deformity with many etiologic factors. Different corrective procedures using Ilizarov external fixation have been described which include, soft tissue release, V-osteotomy, multiple osteotomies and triple fusion.


METHODS
In this study we compare the results of two groups of skeletally mature patients with complex foot deformity who were treated by two different protocols. The first group (27 patients, 29 feet) was treated by triple fusion fixed by Ilizarov external fixator until union. The second group (29 patients, 30 feet), was treated by triple fusion with initial fixation by Ilizarov external fixation until correction of the deformity was achieved clinically, and then the Ilizarov fixation was replaced by internal fixation using percutaneous screws. Both groups were compared as regard the surgical outcome and the incidence of complications.


RESULTS
There was statistically significant difference between the two groups regarding duration of external fixation and duration of casting with shorter duration in the group 2. Also there was statistically significant difference between both groups regarding pin tract infection with less incidence in group 2.


CONCLUSIONS
Early removal of Ilizarov external fixation after correction of the deformity and percutaneous internal fixation using 6.5 cannulated screws can shorten the duration of treatment and be more comfortable for the patient with a low risk of recurrence or infection.
Department of Orthopaedic Surgery, Ain Shams Univ. Hospitals, Cairo, Egypt. kmemara@hotmail.com
Khaled
K
Emara
El Hussein
el H
El Moatasem
Ossama
O
El Shazly
D000293:Adolescent; D000328:Adult; D016267:External Fixators; D005260:Female; D005530:Foot Deformities / Q000601:surgery*; D006801:Humans; D018889:Ilizarov Technique / Q000295:instrumentation; D016268:Internal Fixators; D008297:Male; D012189:Retrospective Studies; D055815:Young Adult