Correction of neuromuscular foot deformity by a circular frame

Abstract

Background Neuropathic deformities impair foot and ankle joint mobility, often leading to abnormal stresses and impact forces. Neuropathic foot deformities present a formidable challenge to orthopedic, pediatric, and rehabilitation specialists since these deformities are multiplanar, insidious in onset, and most difficult to attribute to and recognize an incipient cause. Aim The aim of our study was to determine the use of a circular frame in the correction of neuromuscular foot deformity. The aim of surgical treatment is to achieve painless foot and stable plantigrade. The use of a circular frame, with or without gradual correction, may allow the patient to be more functional during the period of healing because a circular frame will typically allow partial to full weight bearing during the period of recovery. Patients and methods In this study, 18 feet and ankle deformities in 13 patients were operated upon using the Ilizarov technique and fixator during the period from January 2013 to April 2018. Results The aim of surgery in neuropathic foot is to achieve functional improvements and not just a cosmetically normal limb. Compared with the preoperative status, all patients were satisfied with their gait. The correction period ranged from 2 to 3.5 months. Conclusion We have treated 13 patients affected by neuropathic foot deformities caused by poliomyelitis, meningocele, Charcot–Marie–Tooth syndrome, and post compartmental. Correction of foot deformities and leg-length discrepancy was performed by the Ilizarov method to obtain stable plantigrade and enable wearing of a normal shoe. Multiple surgical techniques were used (closed method, arthrodesis, open method with osteotomy, leg or tendoachilles’ lengthening) in most of the patients, with few complications.