title: The management of the neglected congenital foot deformity in the older child with the Taylor spatial frame.
abstract: BACKGROUND
  Neglected or inadequately treated rigid congenitally deformed feet in older children are a nightmarish challenge for the child, the parents, and the orthopaedic surgeon. Because of the multiplicity of spatial deformities exhibited by these feet and legs, it was hypothesized that correction using the Taylor spatial frame (TSF) would decrease morbidity, facilitate correction, and minimize treatment time in children from remote regions with extremely rigid deformed feet.
  
  
  METHODS
  Recent experience with the management of 11 such feet (Dimeglio type IV) in 9 children with an average age of 9.2 years using the TSF has been gratifying. Six children had associated leg length discrepancy, which was corrected by concomitant tibial lengthening. All feet underwent soft tissue releases, whereas forefoot and/or hindfoot osteotomies were performed in 7 feet.
  
  
  RESULTS
  All children attained plantigrade, functional feet, and were fully ambulatory and capable of wearing normal footwear. Complications were minor consisting of pin tract infections, residual metatarsus varus in 3, and wound dehiscence in 1. There were no neurovascular events. This was attributed to the slower 3 plane correction using the TSF technique as well as the elimination of the need for plaster immobilization thus allowing direct monitoring of the foot and limb.
  
  
  CONCLUSIONS
  The rigid foot deformity in the older child can be safely and effectively corrected with the aid of the TSF, which facilitates a 3 plane correction and concomitant limb lengthening.
authors.affiliation: Sheikh Khalifa, Medical City, Abu Dhabi, UAE.
authors.forename: Atef
authors.initials: A
authors.lastname: Hassan
authors.forename: Merv
authors.initials: M
authors.lastname: Letts
mesh_terms: D000293:Adolescent; D000367:Age Factors; D001852:Bone Lengthening / Q000379:methods*; D002648:Child; D005260:Female; D005500:Follow-Up Studies; D005532:Foot Deformities, Congenital / Q000601:surgery*; D006801:Humans; D018889:Ilizarov Technique; D007870:Leg Length Inequality / Q000209:etiology / Q000601:surgery*; D008297:Male; D019637:Orthopedic Procedures / Q000379:methods*; D010027:Osteotomy / Q000379:methods; D011183:Postoperative Complications / Q000453:epidemiology; D013977:Tibia / Q000601:surgery; D013997:Time Factors; D016896:Treatment Outcome