Initial management of severe rigid clubfoot using a simplified Ilizarov external fixator. Case report

Abstract

Clubfoot is the most common congenital deformity in feet. Ponseti ´s method is the reference treatment for this condition. Surgical treatment is usually necessary when rigidity and deformity are severe and cannot be addressed by manipulations. In severe cases, the surgical correction could put the medial neurovascular structures of the foot at risk, and sometimes are associated with delayed wound closure problems. In severe deformities, gradual correction prior to surgery can be achieved with circular external fixation, but the assemblies are difficult and complex to perform, thus limiting its application, particularly with small feet. A simplified assembly with an Ilizarov external fixator, designed by us, was used for the treatment of these feet. This modification allows a gradual correction of the deformity, regardless of the degree of stiffness and foot size. The case is presented of a 3-year-old male patient, diagnosed with recurrent congenital clubfoot treated with this assembly and later with a total soft tissue release.
Evidence level IV.