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ANKLE ARTHRODESIS WITH ILIZAROV EXTERNAL FIXATOR FOR SEVERE POST TRAUMATIC DEGENERATIVE CHANGES



Abstract

Purpose: We report our experience with ankle arthrodesis using Ilizarov External fixator in 18 patients with extensive damage of the ankle joint, mainly with post traumatic osteoarthrosis, during the last 7 years.

Materials and Methods: The mean age of the patients was 36 years (range 21–54 years). 14 Pts had posttraumatic arthrosis following complicated intraarticular fractures, 3 Pts had extensive osteochondritis dissecance and 1 had failure of union after RAF arthrodesis of ankle. No cases of osteomyelitis of ankle were included in this seria. All procedures were done with open arthrotomy, 6 through lateral approach and 12 through anterior approach. Bone grafting was used in 3 cases due to extensive damage of talar bone. Temporary fixation by Steinman pin was done in all cases after open alignment of ankle joint, and then Ilizarov external fixator was applied, followed by removal of the temporary fixation. Full weight bearing was allowed from the 3rd or 4th postoperative day. Time in fixator ranged from 6 to 14 weeks (average 9,5 weeks).

Results: Solid arthrodesis was achieved in all cases. 15 patients were free of pain, 2 patients continued to complain of pain due to degenerative changes in subtalar joint which presented before surgery. 1 patient developed RSD and was treated successfully by analgesics and physiotherapy. 5 cases of superficial pin tract infection were observed and treated with antibiotics. There were no cases of deep wound infection in this series.

Conclusions: This method has been proven useful for primary arthrodesis of ankle joint, mainly for complicated cases after multiple surgeries, or in patients with advanced post-taumatic changes.

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