Tibial lengthening and concomitant foot deformity correction in 14 patients with permanent deformity after poliomyelitis

Hae Ryong Song, Valencia Myrboh, Chang Wug Oh, Sung Tae Lee, Suk Ha Lee

Research output: Contribution to journalArticle

18 Citations (Scopus)

Abstract

Background: In neuromuscular diseases, limb lengthening and foot deformity correction are associated with a high risk of complications associated with distraction callus and joint contracture. We have found no published articles of tibial lengthening and concomitant foot deformity correction using the Ilizarov method or traditional methods. To compare result of gradual distraction with triple arthrodesis for foot deformity combined with tibial lengthening, we investigated healing index and complications of two methods. Patients and methods: We reviewed 14 patients with permanent deformity after poliomyelitis who underwent tibial lengthening and concomitant foot deformity correction using the Ilizarov external fixator. Tibial lengthening over an intramedullary nail was performed in 3 patients and lengthening without a nail was performed in 11 patients. Results: The mean external fixation time was 6 (3.6-10) months without nail and 1.6 (1.5-1.7) months with nail, whereas the mean healing index was 1.8 (0.8-3.1) months/cm without nail and 2 (1.8-2.3) months/cm with nail. Concomitant foot treatments included triple arthrodesis in 7 patients, pantalar arthrodesis in 2 patients with flail ankle, and gradual foot frame distraction without bony foot procedures in 5 patients. Delayed consolidation and recurrent equinus contracture of the ankle requiring additional lengthening of the Achilles tendon were the most common bone and joint complications during tibial lengthening. Interpretation: The gradual foot frame distraction method was associated with major complications, such as recurrent foot deformity, joint luxation, and arthritis. We therefore recommend triple arthrodesis as a concomitant procedure during tibial lengthening.

Original languageEnglish
Pages (from-to)261-269
Number of pages9
JournalActa Orthopaedica
Volume76
Issue number2
DOIs
Publication statusPublished - 2005 Apr 1

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Foot Deformities
Poliomyelitis
Nails
Arthrodesis
Foot
Ankle
Equinus Deformity
Joints
Foot Joints
Ilizarov Technique
External Fixators
Neuromuscular Diseases
Achilles Tendon
Bony Callus
Contracture
Arthritis
Extremities
Bone and Bones

ASJC Scopus subject areas

  • Orthopedics and Sports Medicine
  • Surgery

Cite this

Tibial lengthening and concomitant foot deformity correction in 14 patients with permanent deformity after poliomyelitis. / Song, Hae Ryong; Myrboh, Valencia; Oh, Chang Wug; Lee, Sung Tae; Lee, Suk Ha.

In: Acta Orthopaedica, Vol. 76, No. 2, 01.04.2005, p. 261-269.

Research output: Contribution to journalArticle

Song, Hae Ryong ; Myrboh, Valencia ; Oh, Chang Wug ; Lee, Sung Tae ; Lee, Suk Ha. / Tibial lengthening and concomitant foot deformity correction in 14 patients with permanent deformity after poliomyelitis. In: Acta Orthopaedica. 2005 ; Vol. 76, No. 2. pp. 261-269.
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