Correction of the neglected clubfoot by the Ilizarov method

Untreated clubfoot deformity remains a significant problem for the orthopaedist practicing in Third World countries. Using gradual distraction applied through the Ilizarov external fixator, 12 cases of neglected clubfoot deformity in seven adult patients were successfully treated at the General Hospital for the Mexican Institute of Social Security. The two men and five women ranged in age from 19 to 42 years (mean, 27 years). These minimally constrained frames required five to eight months of fixation time to achieve the correction. When a plantar-grade position was achieved, the fixator was removed and a below-knee walking cast applied. The follow-up time ranged from two to five years. Complete correction was obtained in all patients, and adductus deformity recurred in three. Feet were stiff before and after treatment, especially the forefoot. Postoperative ambulation seemed to restore some motion.