[CORRECTION OF TRAUMATIC TALIPES EQUINOVARUS WITH Ilizarov AND NON-FUSION TECHNIQUES]

To investigate the effectiveness of the Ilizarov technique for the treatment of traumatic talipes equinovarus so as to provide the evidence for the clinical practice.

Between February 2011 and April 2012, 42 patients with traumatic talipes equinovarus received treatment by Ilizarov technique, including 29 males and 13 females aged 17-55 years (mean, 34.3 years). The left side was involved in 24 cases, and the right side in 18 cases. The disease duration was 6 months to 6 years (mean, 2.7 years). According to the principles of Ilizarov, a ring external fixator was applied on the affected foot and lower leg. The threaded rods and screw nuts were revolved according to the tolerance of patients at 3-7 days after fixation. At first, forefoot varus or foot inversion was corrected, and then drooping feet deformity was corrected. The patients were encouraged to begin weight-bearing walking after correction. X-ray films were taken regularly to observe the ankle joint and avoid its dislocation. The external fixator was maintained in neutral position for 8-12 weeks after achieving satisfactory correction. An walking ankle-foot orthosis and a sleeping ankle-foot orthosis were used for more than 16 weeks after removal of the fixator. The outcome was assessed with American Orthopaedic Foot and Ankle Society (AOFAS) comprehensive scoring system and visual analogue scale (VAS) pain score.

Forty-two patients were followed up 14.3 months on average (range, 10-24 months). All the patients achieved 0° dorsiflexion at 4-13 weeks (mean, 6.8 weeks) after treatment with Ilizarov apparatus. The fixator was maintained for 10.7 weeks on average (range, 10-16 weeks) after correction. No dislocation of the ankle joint and no damage to nerves and blood vessels occurred. The deformity of plantar flexion (10°) was found in 3 patients. At last follow-up, the patients could walk normally. AOFAS score was significantly increased to 93.4 ± 8.0 from 52.7 ± 10.1 at preoperation (t = -7.035, P = 0.008); according to AOFAS scoring system, 24 cases were grades as excellent, 14 as good, 2 as moderate, and 2 as poor, and the excellent and good rate was 90.5%. The VAS score of the foot significantly decreased to 3.51 1.44 from 7.55 ± 1.39 at preoperation (t = -0.564, P = 0.025).

Ilizarov technique combined with non-fusion has satisfactory effectiveness in correction of traumatic talipes equinovarus. It is a safe, effective, and minimally invasive method.