July highlighted article Author’s Comment

Treatment of Severe Rigid Posttraumatic Equinus Deformity With Gradual Deformity Correction and Arthroscopic Ankle Arthrodesis

Patricio Fuentes, MD

Department of Orthopedic Surgery
 Foot and Ankle Unit,
Hospital del Trabajador
 Santiago, Chile

 

Our group has developed solid expertise in managing posttraumatic foot sequelae, a product of continuous work in major trauma centers in our country.

Following our experience in limb lengthening and reconstruction surgery, we have performed multiple corrections of congenital foot and ankle deformities with hexapod ring fixators.

The combination of these techniques allowed us to reach an effective strategy for the management of post-traumatic deformities with minimal soft tissue disruption.

Severe non-plantigrade equinus deformities result in major difficulties for ambulation and limitation of most activities of daily living. These rigid deformities are often associated with poor skin conditions and multiple prior surgeries.

Open acute correction has been described using osteotomies, talectomy and arthrodesis but concerns exist about skin complications, neurologic alterations, secondary limb discrepancy, bone loss and recurrence.

Gradual correction using a hexapod external fixator with limited percutaneous soft tissue releases and arthroscopic ankle arthrodesis (AAA) may decrease these complications and can benefit limb preservation.

We present a case series of five patients with severe rigid posttraumatic equinus treated with this strategy. Our results permit us to consider this procedure as effective and reproducible, with a high satisfaction rate at a minimum of one-year follow-up.

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