Using the Ilizarov technique in combination with osteotomy and soft tissue balance is a safe and effective way to correct complex foot deformities and associated lower limb deformities, a new study finds.
Ilizarov Technique With Osteotomy Can Help Fix Foot Deformities
1 min read Premium comments
Secondary#complexfootdeformities#lowerlimbdeformities
In the study, “Complex foot deformities associated with lower limb deformities: a new therapeutic strategy for simultaneous correction using Ilizarov procedure together with osteotomy and soft tissue release,” published online on October 23, 2020 in the Journal of Orthopaedic Surgery and Research, the researchers tested a new therapeutic strategy.
The retrospective review analyzed data from 2015 to 2019 on the simultaneous correction of complex foot deformities (CFD) and the associated lower limb deformities (LLD) using the Ilizarov procedure together with osteotomy and soft tissue balance.
Overall, 32 patients were included in the study with an average follow-up of 42.8 months. The mean external fixation time was 6.5 months; the mean healing index 1.7 months/cm.
By the time the fixator was removed, plantigrade feet were achieved in all patients and all lower limb deformities were corrected.
None of the deformities returned. The mean LLRS AIM score was improved from 7.5 to 0.3. By the final follow-up, the ASAMI-Paley score was excellent in all limbs. Functional results were also excellent in 90.6% of limbs and good in 3 limbs.
The mean modified Dimeglioscore was also significantly improved from 7.2 to 1.3. There were no severe infections at the osteotomy site or any nonunions reported.
The researchers wrote, “Treatment of complex foot deformity combined with lower limb deformity by using the Ilizarov technique together with osteotomy and soft tissue procedure usually achieves good results. However, this method has a long learning curve. Many details still need to be continuously improved in practice.”
They added, “Therefore, before starting treatment of any complex deformity, it is important to grasp the patient’s expectation. Surgeons should give a realistic explanation of what the deformity correction will accomplish, what the foot will be like in the corrected position, and the functional limitations.”
React:
Discussion
This is a fascinating development. In my practice we've seen similar outcomes with the revised protocol. The key differentiator seems to be patient selection criteria. Has anyone else noticed the correlation with BMI thresholds?
Great point. I'd push back slightly on the conclusion, the sample size in the cited study is too small to draw population-level inferences. That said, the directional signal is compelling and worth a larger RCT.
We implemented a similar approach last year. Early results are promising but we're still gathering 12-month follow-up data. Happy to share our protocol if anyone is interested.
Join the conversation
Orthopedic professionals are discussing this. Sign in and upgrade to read every comment and add your voice.