title: Treatment of posttraumatic equinus deformity and concomitant soft tissue defects of the heel.
abstract: BACKGROUND
  To evaluate the operative method and clinical outcome for the treatment of posttraumatic equinus deformity and concomitant soft tissue defect of the heel.
  
  
  METHODS
  Between June 2006 and May 2010, seven cases of posttraumatic equinus deformity and concomitant unstable scar or ulcer of the heels were treated by using a hinged Ilizarov apparatus and reversed sural fasciocutaneous island flap transfer. Achilles tendon lengthening was also done in all patients. The average duration of follow-up was 21 months. The sizes of sural flaps were from 7 cm × 6 cm to 10 cm × 9 cm. Two weeks after the flap transfer, distraction of the Ilizarov fixator was initiated to gradually correct the equinus position of the foot.
  
  
  RESULTS
  Results were evaluated by using the following criteria: (1) the degree of active dorsiflexion of the ankle, (2) the total active range of motion of the ankle, and (3) walking ability and flap durability. For active dorsiflexion of the ankle, the results were good in three patients and fair in four patients. For range of active motion of the ankle, the results were good in five patients and fair in two patients. For walking ability and flap durability, the results were good in six patients and fair in one patient.
  
  
  CONCLUSIONS
  This study showed that posttraumatic equinus deformity accompanied by soft tissue defect of the heel can be treated effectively with Achilles tendon lengthening, reversed sural fasciocutaneous island flap transfer, and a hinged Ilizarov technique.
authors.affiliation: Department of Orthopaedic Traumatology, The Graduate School, Tianjin Medical University, Tianjin Hospital, Tianjin, People's Republic of China.
authors.forename: Hengsheng
authors.initials: H
authors.lastname: Shu
authors.forename: Baotong
authors.initials: B
authors.lastname: Ma
authors.forename: Shilian
authors.initials: S
authors.lastname: Kan
authors.forename: Hongchuan
authors.initials: H
authors.lastname: Wang
authors.forename: Heng
authors.initials: H
authors.lastname: Shao
authors.forename: J Tracy
authors.initials: JT
authors.lastname: Watson
mesh_terms: D000063:Accidents, Traffic; D000328:Adult; D002921:Cicatrix / Q000601:surgery; D003131:Combined Modality Therapy; D004863:Equinus Deformity / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D005500:Follow-Up Studies; D018409:Foot Injuries / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D006365:Heel / Q000503:physiopathology / Q000601:surgery; D006801:Humans; D018889:Ilizarov Technique; D008297:Male; D008875:Middle Aged; D020127:Recovery of Function; D012189:Retrospective Studies; D012494:Sampling Studies; D017695:Soft Tissue Injuries / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D013524:Surgical Flaps; D016896:Treatment Outcome; D014945:Wound Healing / Q000502:physiology; D014947:Wounds and Injuries / Q000150:complications; D055815:Young Adult