EC Orthopaedics

Overview: Neglected club foot deformity is common in our part of the world due to underdeveloped health facilities in a far flung areas. As the age progresses, the deformity becomes very rigid and with thick large callosity over lateral plantar arch of the foot. Foot remains rigidly supinated, forefoot in adduction, heel in varus and equinus position. Neglected congenital Talipes Equiano Varus has severe deformity. Correction of rigid foot deformity with Ilizarov is beneficial as it corrects all deformities of TEV foot.

Materials and Methods: Prospective study conducted in Rawalpindi Medical University Hospital from 2008-2017. Cases selected were mature foot or near maturity. Frame was kept for 6 weeks after full correction, casts were replaced every 6 weeks, for a total of 12 weeks. Patient weight bearing, comfort was noted in a pre and postoperative scoring table.

Results: A total of 10 patients, 16 feet were included in this study. Mean age was 17.5 years (SD ± 9.45) with range of 8 to 40 years. Deformity severity score was built with maximum score of 12 and least deformity score as 0.

Discussion: Treatment of neglected CTEV is adults is a great challenge, till the age of 20 if not treated has been considered as candidate for amputation and prosthesis. Extensive soft tissue release, bony wedge resections, excision of talus with triple or pantalar arthrodesis has been reported in literature. Use of Ilizarov became a popular success provided correct frame application is done. Notable complications included neuromuscular compromise, skin stretch and cut from wire, infection, subluxation of tarsal bone.

Keywords: Congenital Talipes Equiano Varus; Club Foot Deformity; Mature Foot Correction; Ilizarov Fixator

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