Nuno Craveiro Lopes M.D. 

Head of Orthopedic and Traumatologic Department
Coordinator of Pediatric Orthopedics  and Limb Reconstructive Surgery Unit
Garcia de Orta Hospital, Almada - Portugal

Any comment, suggestion or contact can be done to: [email protected]

CLINICAL CASE PRESENTATION

Treatment of relapsed club foot with a open Ilizarov frame without bone correction (1996)

6 yo girl presenting a left clubfoot treated initially with manipulation and casting, and latter operated with a postero-medial release by Cincinnati method. She had a relapse. 

Percutaneous Aquiles tenotomy and plantar fasciotomy were performed.

A preassembled Ilizarov frame was applied, including a base with two rings on the tibia, and arch on the calcaneous and another arch on the metatarsus. Two motors were applied between the base and calcaneal arch to correct rear foot varus and equinus, one motor in between calcaneal and metatarsal arches to correct forefoot adductus, and another motor in between base and metatarsal arch, to correct forefoot equinus. If forefoot supination existed, two motors will be connected here to derotate de forefoot.

This frame was no bars or hinges on the lateral aspect of the frame because the hinge points are the foot joints themselves.

We use this type of frame we call open frame, in children with less than 15 yo with mobile joints.

Treatment lasted for 3 moths: one month for correction with the frame, one month with the frame static and one month with a plaster boot. After that the patient used a night splint until the end of growth. 

One of the main characteristics of this methodology is the ability to lengthen the foot to its original dimensions.