Abstract
Pes equinovarus is a congenital disease that can be successfully treated with serial casting and percutaneous achillotomy at the newborn stage in most of the cases. Complex surgical interventions are required for patients presenting at advanced age for correction of this deformity. The main problem encountered in the treatment for neglected pes equinovarus cases is repairing the posteromedial skin defect of the ankle due to surgical correction of this deformity. The sural flap is frequently used in the repair of a number of skin defects on the ankles, although reports on the use of this flap in pes equinovarus surgery are scarce. In this article, the technical details of sural flap application in cases with neglected pes equinovarus and the preliminary results of three extremities treated with this method have been presented.
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Horn BD, Davidson RS (2010) Current treatment of clubfoot in infancy and childhood. Foot Ankle Clin 15:235–243
D’Souza HH, Aroojis AA, Yagnik MG, Nagda TV (1996) Rotation fasciocutaneous flap for neglected club feet—a new technique. J Postgrad Med 42:112–114
Lubicky JP, Altiok H (2001) Regional fasciocutaneous flap closure for clubfoot surgery. J Pediatr Orthop 21:50–54
Szabó G, Mester S, Tóth F (2005) Cincinnati incision combined with medial rotation fasciocutaneous flap for clubfeet with pathologic soft tissues. Orthopedics 28:368–370
Kamath BJ, Bhardwaj P (2005) Local flap coverage following posteromedial release in clubfoot surgery in older children. Int Orthop 29:39–41
Mittal RL (1987) The surgical management of resistant clubfoot by rotational skin flap and extensive soft tissue release. Int Orthop 11:189–192
Reize C, Ulrich Exner G (2007) Acute correction of severe neglected club feet using a circumferential incision. J Pediatr Orthop B 16:213–215
Walker G (1971) The early management of varus feet in myelomeningocele. J Bone Joint Surg Br 53:462–467
Rosselli P, Reyes R, Medina A, Céspedes LJ (2005) Use of a soft tissue expander before surgical treatment of clubfoot in children and adolescents. J Pediatr Orthop 25:353–356
Roposch A, Steinwender G, Linhart WE (1999) Implantation of a soft-tissue expander before operation for club foot in children. J Bone Joint Surg Br 81:398–401
Hassan FO, Jabaiti S, El tamimi T (2010) Complete subtalar release for older children who had recurrent clubfoot deformity. Foot Ankle Surg 16:38–44
Rohmiller MT, Callahan BS (2005) The reverse sural neurocutaneous flap for hindfoot and ankle coverage: experience and review of the literature. Orthopedics 28:1449–1453
Follmar KE, Baccarani A, Baumeister SP, Levin LS, Erdmann D (2007) The distally based sural flap. Plast Reconstr Surg 119:138–148
Turco VJ (1979) Resistant congenital club foot—one-stage posteromedial release with internal fixation. A follow-up report of a fifteen-year experience. J Bone Joint Surg Am 61:805–814
Hsu WK, Bhatia NN, Raskin A, Otsuka NY (2007) Wound complications from idiopathic clubfoot surgery: a comparison of the modified Turco and the Cincinnati treatment methods. J Pediatr Orthop 27:329–332
Uglow MG, Clarke NMP (2000) Relapse in staged surgery for congenital talipes equino varus. J Bone Joint Surg Br 82:739–743
Atar D, Lehman WB, Grant AD (1991) Complications in club foot surgery. Orthop Rev 20:233–239
Mountney J, Khan J, Davies AG, Smith TWD (1998) Scar quality from partial or complete wound closure using the Cincinnati incision for club foot surgery. J Pediatr Orthop B 7:223–225
Grill F, Franke J (1987) The Ilizarov distractor for the correction of relapsed or neglected club foot. J Bone Joint Surg 69:593–597
El Barbary H, Abdel Ghani H, Hegazy M (2004) Correction of relapsed or neglected clubfoot using a simple Ilizarov frame. Int Orthop 28:183–186
de la Huerta F (1994) Correction of the neglected club foot by the Ilizarov method. Clin Orthop 301:89–93
Rejholec M (2002) Lateroposteromedial approach with rhomboid flap method for the treatment of severe club foot deformity. Foot Ankle Surg 8:243–249
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Isik, D., Ceylan, M.F., Guner, S. et al. Technical details of using sural flap in pes equinovarus surgery: a preliminary report on the technique. Eur J Orthop Surg Traumatol 22, 521–525 (2012). https://doi.org/10.1007/s00590-011-0854-2
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DOI: https://doi.org/10.1007/s00590-011-0854-2