Treatment Of Clubfoot In Older Children With ILIZAROV External Fixtaor

Objective:To study the results of treatment of clubfoot in older children(above 6 years old).Method:46 patients(56 feet) with clubfoot,including 26 males and 20 females,were treated in this hospital from June 2006 to June 2010.Of these patients,there are 36 unilateral and 10 bilateral deformities.The ages of the patients ranged from 6 years to 16 years.According to the etiopathogenisis,all patients were divided into congenital group(group A) and traumatic group(group B).There were 31 patients(41 feet) in group A and 15 patients(15 feet) in group B.All the feet were evaluated by ICFSG scoring systerm,including morphology(12 points),functional evaluation(36 points) and radiological evaluation(12 points),from the normal 0 to the most serious abnormal 60 points.0 to 5 points was excellent,6 to 15 points was good,16 to 30 points was general and 31 to 60 points was poor .Preoperative scores of 56 feet were marked. 0 was excellent,0 was good,17 feet were general(11 feet were in group A and 6 feet were in group B) and 39 feet were poor(30 feet were in group A and 9 feet were in group B).According to the patient's age, degree and nature of deformity and with or without severe bone deformity,46 patiens were all treated with Ilizarov external fixators combined with limited operation such as soft tissue release,achills tendon extension and V-shaped osteotomies of the talonavicular joint.Result:All of the 46 patients(56 feet) were followed up from 9 months to 4 years.The results were assessed using ICFSG scoring systerm.40 feet(30 feet were in group A and 10 feet were in group B) were excellent,11 feet(8 feet were in group A and 3 feet were in group B) were good,5 feet(3 feet were in group A and 2 feet were in group B) were general and 0 poor.The effect was excellent.3 patients had pin hole reaction and 0 had residual deformity. The excellent rate was analyzed with SPSS17.0 and the result showed no significant differences between the two groups(P>0.05).Conclusion:Because of delayed treatment and severe deformity,the older children(6 years old and above) treated with traditional operation would receive poor treatment and be easy to relapse. It was minimally invasive,secure,difficult to relapse and had satisfactory correction of deformity and good function of the ankle joint that to treat clubfoot in older children with the Ilizarov external fixator.It was a good choice to treat clubfoot in older children with Ilizarov external fixator.