Correction of Untreated Severe Talipesequino-Cavovarus Deformity in Both Feet by Transverse Talo-Calcaneal Osteotomy and Gradual Soft Tissue Lengthening by Using an Ilizarov Ring Fixator

A 19 year old girl originating from a developing country presented with an inability to walk normally due to a painful talipes equinocavovarus deformityTalipesequino-cavovarus deformity in both feet, resulting from a flaccid paralysis, probably due to anterior horn cell disease. Both forefeet were turned upside down, forcing the patient to walk on the balls of the feet. Such a complex foot deformityComplex foot deformity with multiplanar abnormalities and severe soft tissue contractures in the foot may not be corrected by conventional surgical treatment. The left leg was affected by shortening due to an untreated congenital hip dislocation. The decision was made to correct both feet by stretching the soft tissues gradually using the Ilizarov ring fixatorIlizarov ring fixator following an osteotomy at the level of the talonavicular joint. Following correction the left side underwent a pantalar arthrodesis into an equinus position to facilitate leg length equalization. On the right side, the foot was corrected into a mild equinus position. After these procedures, the patient was able to walk pain-free using orthopedic shoes with a shoe heel raise on the left side.