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INTERNAL FIXATION VERSUS ILIZAROV APPARATUS IN SUBTALAR ARTHRODESIS



Abstract

Purpose: Comparison of functional, anatomical and roenthgenological outcomes of subtalar arthrodesis technique: Ilizarov apparatus- EF and internal fixation IF.

Materials and Methods: 41 patients (31 men, 10 women) , average age of 38.8 years (12–71) with 44 symptomatic feet underwent procedures for painful arthrodeses. In 28 (30 feet) we performed subtalar arthrodeses by lateral approach, rigid internal fixation with screws.

13(14 feet) others underwent minimal invasive intervention and compression arthrodesis using Ilizarov frame. Nonweightbearing for 4–6 weeks. Removal – 8–10 weeks after the procedure.

Evaluation: subjective complaints, physical examination, postoperative radiographs. Patient suspected to have union problems underwent a CT.

Results:

In IF union rate 90% (25 patients).

Complications: Three re-arthrodeses for nonunion, entrapment of sural nerve – 2 patients, postoperative infection – 2 patients, postoperative infection – 2 patients. In one case intravenous antibiotic resolved the problem, another one needed surgical debridement. The IF overall results were excellent in 79%, good in 12%, fair in 9%.

In group EF – solid bone fusion was obtained in all patients. Pin tract infection treated in four, in one case with reinsertion of KW.

Conclusions:

  1. Ilizarov external frame is superior for fusion.

  2. Disadvantages: Pin tract infection and rare sensory disturbances.

  3. Older arthritic patients have fewer complications.

  4. Period for bone fusion was shorter in EF group

The abstracts were prepared by Ms Orah Naor. Correspondence should be addressed to Israel Orthopaedic Association at PO Box 7845, Haifa 31074, Israel.