Out Come of Ankle Arthrodesis with Ilizarov Method
Objectives: To determine the functional and radiological outcome of arthrodesis of the ankle using the ilizarov method.
This descriptive study was conducted in Bolan Medical Complex Hospital Quetta and National institute of Rehabilitation Medicine Islamabad, from January 2015 to December 2018.Twenty patients fulfilling the inclusion criteria under went arthrodesis of the ankle using ilizarov method. At follow up visit patients were assessed clinically for pain and walking and radiologically for union.
Results: A total of 20 patients with mean age 41.0 years ± 13.61 were included in our study. In 18(90%) a stable pain free ankle arthrodesis was achieved successfully after a mean ilizarov external fixator time of 147 days (range 105-195 days). There were minimal complications despite early weight bearing. No further surgery was required except in 02(10%) cases in which primary arthrodesis was not achieved.
Conclusion: Ilizarov external fixator used for ankle arthrodesis give excellent stability, allowing early weight bearing without pain and results in higher rates of union with minimal post operative complications.
2 Murphy GA. Arthrodesis of the ankle.In;Canale ST, Beaty JH, editors, Campbell’s Operative Orthopaedics.12th ed.Philadelphia; Elsevier Mosby 2013:1123-1138.
3 El-Gafary AM, Mostafa KM, El-Adly W. The management of Charcot joint disease affecting the ankle and foot by arthrodesis control by a ilizarov frame. J Bone Joint Surg[Br] 2009; 91(10):1322-5.
4 Kugan R, Aslam N, Bose D,McNally MA. Outcome of arthrodesis of the hindfoot as a salvage procedure for complex ankle pathology using the ilizarov technique. Bone Joint J 2013; 95-B: 371-7.DOI: 10.1302/0301-620X.95B3.29885
5 Calif E, Stein H, Lerner A. The ilizarov external fixation frame in comprssion orthrodesis of large weight bearing joints. Acta Othop Belg 2004;70:51-56.
6 Kotnis R, Pasapula C, Anwar F, Cooke PH, Sharp RJ. The management of failed ankle replacement. J Bone Joint Surg [Br] 2006;88-B:1039-47.
7 Oostenbroek HJ, Van Roermund PM. Arthrodesis of the knee after an infected arthroplasty using the ilizarov method. J Bone joint Surg [Br] 2001;83-B:50-40
8 Albers WE. Arthrodesis of the knee. In : Canale ST, Beaty JH, editors. Campbell’s Operative Orthopaedics 12th ed. Philadelphia: Elsevier Mosby 2013; 1230-1280.
9 Rowan R, Davey KJ. Ankle arthrodesis using an anterior AO T plate. The Bone & Joint Journal 1999;81(1):113-6.
10 Braly WG, Baker JK, Tullos HS . Arthrodesis of the ankle with lateral plating.Foot and Ankle 1994;15:649
11 Gruen GS, Mears DC. Arthrodesis of the ankle and sub taller joints. Clin Orthop Relate Res 1991;268:15-20.
12 Moore TJ Prince R, Pochatko D, Smith JW, Fleming S.Retrograde intramedullary nailing for ankle arthrodesis. Foot and Ankle Int 1995;16:433-6.
13 Weltmer JB Jr, Choi SH, Shenoy A, Schwartsman V. Wolf blade plate ankle arhrodesis. Clin Orthop Relate Res 1991;268:107-111.
14 Shalaby S, Shalaby H,Bassiony A. Limb salvage for osteosarcoma of the distal tibia with resection arthrodesis, autogenous fibular graft and ilizarov external fixator. J Bone Joint Surg [Br]2006, 88-B;1642-6.
15 Carrier DA, Harris CM. Ankle arthrodesis with vertical steinman pins in rheumatoid arthritis. Clin Orthop Relate Res 1991;268:10
16 White SP, Porteous AJ, Newman JH, Mintowt-Czyz W, Barr V. Arthrodesis of the knee using a custom made intramedularly coupled device. J Bone Joint Surg [Br] 2003;85-B;57-61
17 Monzott A, Pullen C, Guerreschi F, Catagni MA. Knee arthrodesis and limb lengthening in the treatment of infected total knee arthroplasty: case report. J Trauma. 2002 Feb;52(2):359-63.
18 Manzotti A, Pullen C, Deromedis B, Catagni MA.Knee arthrodesis after infected total knee arthroplasty using the ilizarov method. Clin Ortho Relat Res 2001;(389):143-9.
19 Hayes BJ, Gonzalez T, Smith JT, Chiodo CP, Bluman EM.Ankle arthritis: You can’t always replace it. J Am Acad Orthop Surg 2016;24;29-38
20 Calif E, Stein H, Lerner A. The Ilizarov external fixation frame in compression arthrodesis of large, weight bearing joints. Acta Orthop Belg 2004;70:51-56
21 Kovoor CC, Padmanabhan V, Bhaskar D, George VV, Viswanath S.Ankle fusion for bone loss around the ankle joint using the ilizarov technique. J Bone Joint Surg 2009;91-B:361-6.
22 Katsenis D, Bhave A, Paley D, Herzenberg JE. Treatment of malunion and nonunion at the site of ankle fusion with the Ilizarov apparatus. J Bone Joint Surg Am.2005 Feb;87(2):302-9.