Chronic deformities of the lower extremity caused by severe burns are difficult problems because there is often severe soft tissue loss associated with the injury and rigid scar formation. Deformities associated with burns includetibial shortness, ankle equinus, cavus, varu, or valgus, rocker bottom, metatarsal and toe deformities. Often, these deformities can be prevented with aggressive early rehabilitation and correct positioning of the foot and ankle using splints during acute burn care.
However, if foot and ankle deformities occur, they are disabling problems that require aggressive treatment to improve function. Treatment options include physical therapy, soft tissue release, osteotomies, bone resection, amputation, and the Ilizarov method. Burn deformity of the foot and ankle can be classified as either simple or complex. Simple deformities are unidirectional, have normal bone and soft tissue structure, and can be sometimes treated with traditional surgical techniques.
Complex deformities, on the other hand, have multiple components, such asequinus with loss of muscle function or equinocavus with valgus deformity, and require more complicated treatment and maintenance. Historically, amputation was the only treatment option for most severe cases. Now, however, treatment with the Ilizatrov method offers the possibility of limb salvage for these patients.