الفهرس 
Introduction and Aim of workOnly 14 pages are availabe for public view
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Abstract
Summary
About 25% of operated clubfeet will develop recurrence or show a marked residual deformity. As main factor, the failure of concentric reduction at the time of initial surgery has to be considered. Residual forefoot adduction and supination are the most common persistent deformities.
The incidence of relapse, recently recorded as 50% and even up to 84%. Methods of classification, evaluation assessment and treatment of this problem were advanced over many years. This review of literature is a close up approach to the problem of relapsed clubfoot, aiming to get the best for treatment of this resistant problem.
Some authors report good results with soft tissue release even at 8-10years of age (Grill and Frank, 1987). Other authors are contrary to this.
All of these procedures, however, are indicated in relapsed clubfeet with only one predominant component.
In cases with severe deformity, the prevalent opinion is to wait until skeletal maturity, or at least until the age of 12, and to perform wedge osteotomies with arthrodesis of the subtalar and midtarsal joint, often preceded by soft tissue release.
All of these procedures are technically demanding and are liable to complication such as skin necrosis, pseudoarthrosis, infection or vascular damage.
By using Ilizarov apparatus it is possible to treat severely deformed clubfeet non-invasively, without bone resection, and without shortening of the foot.
It allows simultaneous correction of all components of the deformity and it is not necessary to wait for the completion of skeletal growth.
In 1951 Ilizarov developed at his institution in Kurgan, Siberia, and a circular external skeletal fixation system that attaches to bone with tensioned transfixation wires.
The Ilizarov apparatus is rigid yet versatile, and the minimal nature of the surgical intervention creates the optimal biologic and mechanical environment for soft tissue correction and early functional rehabilitation.
In our study we modified all of the previous frames to get a simple, easy, cheap, light and very rigid frame to use it in correction of relapsed cases of clubfoot or even neglected cases regardless to the cause of relapse or the pathology and the etiology of clubfoot.