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New experiences in treating postburn talipes equinovarus associated with bone and joint pathologic changes
Tianyi Liu1, Danru Wang, Yunliang Qian
1Department of Plastic and Reconstructive Surgery, Shanghai 9th People's Hospital, 639 Zhi Zao Ju Road, Shanghai 200011, China.
Summary
This study presents a simplified surgical technique for postburn talipes equinovarus, successfully enabling patients to walk without crutches. The modified triple arthrodesis technique addresses bone and joint deformities effectively.
Area of Science:
- Orthopedic Surgery
- Burn Reconstruction
- Pediatric Orthopedics
Background:
- Postburn talipes equinovarus presents significant challenges due to associated bone and joint deformities.
- Scar contractures and tissue loss complicate reconstructive efforts.
Purpose of the Study:
- To present a simplified and modified surgical technique for correcting postburn talipes equinovarus.
- To evaluate the efficacy of triple arthrodesis performed directly on scarred tissue.
Main Methods:
- Lengthening of the Achilles tendon and scar tissue.
- Modified triple arthrodesis performed beneath elevated scar tissue attached to periosteum.
- Excision of wedge-shaped bone blocks from the talus, navicular, cuboid, and calcaneus.
Main Results:
- All patients who were previously unable to walk without crutches could ambulate independently postoperatively.
- Good operative results were achieved, enabling functional improvement.
- The modified technique demonstrated successful bone union and wound healing despite scarred tissue.
Conclusions:
- Scar tissue can be safely elevated for arthrodesis if attached to periosteum, minimizing necrosis risk.
- Simplified and modified triple arthrodesis is an effective treatment for postburn talipes equinovarus.
- Functional ambulation can be restored in patients with severe postburn foot deformities.
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