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Published on: April 11, 2012
[Constituted adult equine from the ankle: surgical treatment by Ilizarov external fixator]
F Genêt1, I Laffont, P Denormandie
1Service de rééducation et de réadaptation fonctionnelle, hôpital d'instruction des armées Percy, 101, avenue Henri-Barbusse, 92140 Clamart, France. genet.francois@wanadoo.fr
Introduction:
Ilizarov's external fixator indications are classically used in children to lengthen the lower limbs. This technique is used for adults to gradually correct articular limitations, especially in the knee, ankle and foot.
Method And Results:
We report a case of a 53-year-old patient with distal microangiopathy of the lower limbs leading to amputation of the toes and a bilateral, direct, irreducible, isolated equine feature? from the back foot to 0/50/60 degrees? on retraction of the Achilles tendon. The aim of patient management was to regain walking ability. Because of vascular and cutaneous fragility, the classical surgical treatment was contra-indicated. Progressive reduction by Ilizarov's external fixator was tried. Dorsal inflection was obtained by twice-daily screwing until a radiological angle of 90 degrees was obtained between the tibia and talus. At ten weeks post-surgery, the dorsal voluntary inflection ankle amplitude was symmetrical to 0/10/60 degrees. The patient walked with orthopaedic shoes compensating for the few degrees of residual equine.
Discussion:
Correction of adult equine without osseous deformation by Ilizarov's external fixator should be considered when conventional surgery is contra-indicated.
