Unsuccessful attempts in clubfoot treatment

A 6-year old girl presented for consultation after unsuccessful attempts of clubfoot treatment. The patient suffers from meningomyelocele.

The clinical examination revealed that there was a pitting of the outer surface of the foot, with adduction of the front part thereof. The patient walks with difficulty.

At the age of 2-3 years, the girl underwent two soft tissue operations for correction of foot deformities. The operations (in another hospital) were unsuccessful. In addition, as a consequence of the presence of sores and suspected osteomyelitis, the plastic surgeons twice attempted surgical restoration by covering the wound with a skin graft (unsuccessfully).

Deformity correction was carried out in two stages. In the first stage, under general anaesthesia, the Ilizarov frame was placed and surgical trauma debridement was performed which was then followed by gradual correction of the trauma deformity during the postoperative period.

Thus, due to the deformity correction, ulcer healing was achieved. Two months later, during the second operation, an osteotomy of tibia and fibula was performed for correction of the rotational deformity.

The operation was successful. The results are presented on the photographs:

Before the surgery
After the surgery