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Ilizarov External Fixation for Correcting Complex Postpolio Foot and Ankle Deformity: A Case Study
Bradley M Lamm1, Jordan J Ernst2, Ahmed I Hammouda3
1Chief of Foot & Ankle Surgery, Director, Foot & Ankle Deformity Center, Director, Foot & Ankle Deformity Correction Fellowship, The Paley Institute at St. Mary's Hospital and Palm Beach Children's Hospital, West Palm Beach, FL.
Abstract:
Given their severity and resultant loss of function, postpoliomyelitic foot and ankle deformities require a unique correction method. Correction with dynamic Ilizarov external fixation is one such modality, although it is technically demanding and requires precise preoperative planning. In our case study, a 40-year-old male with a severe postpoliomyelitic equinocavovarus right foot and ankle deformity was treated with gradual correction using dynamic, hinged Ilizarov external fixation. The external fixation was in place for a total of 103 days, with gradual correction performed in 2 successive steps, achieving a functional, plantigrade foot. We maintained this position in a short leg cast for 30 days, followed by bracing and physiotherapy for 6 months. More than 2 years after the index surgery, the patient had achieved a painless and plantigrade foot, allowing for functional ambulation. This method does not require osteotomies, ankle arthrodesis, or tendon transfer.
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