Complications in treatment of older children with congenital clubfoot by Ilizarov external fixator

Background: The purpose of the study was to analyze and describe the complications that arose during the treatment of children aged between 7 and 17 years with congenital clubfoot in the Ilizarov Clinic using the transosseous osteosynthesis method as well as measures for their stopping and prevention.

Methods: In the Ilizarov clinic between 2005 and 2015, 108 patients (126 feet) aged between 7 to 17 years (mean age was 12.2 ± 2.3) with congenital clubfoot were treated. This group of patients was treated by the Ilizarov method with an original external fixator. In patients of this group along with insertion of wires in tibia and foot with the appropriate installation of Ilizarov frame, we used surgical interventions on soft tissues, osteotomies (V-shaped) and stabilizing surgeries (triple arthrodesis).

Results: In the course of treatment complications (inflammation, soft tissue cutting by a wire, premature consolidation of the osteotomy, subluxation in the ankle joint, cutting of the calcaneus by a wire) were observed in 22 patients, which amounted to 20.4% of the total number of patients. All encountered complications were typical for transosseous osteosynthesis and external fixators and were eliminated during treatment and did not affect its final result. In the long-term follow-up period (average 45 months), 93.5% of patients kept the desired result.

Conclusion: Abidance by the methodological principles of transosseous osteosynthesis by Ilizarov in the operative treatment of school-age children with congenital recurrent clubfoot and rational management of patients in the postoperative period is the prevention of complications and contributes to the achievement of the desired result of treatment.