Ankle Arthrodesis with Simultaneous Lengthening of the Lower Limb Using the Ilizarov Fixator

2018 ◽  
Vol 20 (6) ◽  
pp. 441-450
Author(s):  
Karol Mochocki ◽  
Radosław Górski ◽  
Sławomir Żarek ◽  
Łukasz Szelerski ◽  
Paweł Małdyk
Keyword(s):  
Lower Limb ◽  
Weight Bearing ◽  
Kirschner Wire ◽  
Ankle Arthrodesis ◽  
Ilizarov Method ◽  
Comprehensive Treatment ◽  
Foot And Ankle ◽  
Early Weight Bearing ◽  
Ilizarov Fixator ◽  
Tract Infections

Background. Patients with advanced ankle arthrosis or joint deformities and co-existing lower limb shortening present a complex therapeutic problem. This paper presents the Ilizarov treatment as a comprehensive method of simultaneous ankle arthrodesis and equalisation of lower limb length in 18 patients. Material and methods. Eighteen patients with arthrosis, deformities or other conditions of the ankle joint and ipsilateral lower limb shortening were treated with the Ilizarov method. The patients were assessed with the Foot and Ankle Outcomes Questionnaire before the treatment and one year after Ilizarov Fixator removal. Results. The Ilizarov Fixator allows early weight-bearing of the operated limb, which is undoubtedly convenient for the patient. The mean treatment duration was 8.2 months (range 4-18 months). Lower limb lengthening was 4.1 cm on average (range 2.5-8.5 cm). Bone union was achieved in all cases. Radiological and clinical outcomes were satisfactory in all 18 cases. Prolonged regenerate calcification was recorded in 1 patient. Ten patients developed soft tissue pin-tract infections and in 1 patient the Kirschner wire broke. According to the Foot and Ankle Outcomes Questionnaire, patients achieved a notable improvement in daily functioning and quality of life. Conclusions. The outcomes of a comprehensive treatment consisting of ankle arthrodesis and lower-leg lengthening using the Ilizarov method confirm its effectiveness. The Ilizarov Fixator allows early weight-bearing of the operated limb and evaluation at all treatment stages, creating an optimal biological environment for bone healing. The patient recovers functionally to allow satisfactory and pain-free functioning as well as resumption of daily responsibilities. The low incidence of complications adds to the attractiveness of the method.

scholarly journals Ankle Arthrodesis with Cannulated Screw: Case Series

2020 ◽  
Vol 4 (1) ◽  
pp. 87
Author(s):  
Andre Triadi Desnantyo ◽  
Muhammad Zaim Chilmi ◽  
Hizbillah Yazid
Keyword(s):  
Weight Bearing ◽  
Case Series ◽  
Ankle Arthrodesis ◽  
Cannulated Screw ◽  
Average Score ◽  
Foot And Ankle ◽  
Early Weight Bearing ◽  
Sf 36 ◽  
Clinical Scoring ◽  
Hind Foot

ABSTRACT Ankle osteoarthritis patients are young and lack of available long last treatment. Ankle arthrodesis remains the gold standard and is the procedure of choice for younger patients who are heavy laborers. These case series evaluate and report five patients undergone ankle arthrodesis at RSUD Dr. Soetomo Surabaya on 2012-2016. The data were collected from patient files, radiographs, and a recent physical examination. The outcome has been assessed with SF-36 score and clinical scoring system Ankle-Hind foot American Foot and Ankle Society. Three male patients and two female patients underwent ankle arthrodesis with cannulated screw, caused by neglected severe ankle dislocation. One patient had open dislocation. Based on SF-36 scoring, the five patients had average score 76,7 with highest and lowest score were 95,9 and 56,7. Based on clinical score ankle-hind foot American Ankle and Foot Society, the average score was 68(51 – 88). The scoring result includes general health, physic, emotional, and social. And clinical scoring ankle-hind foot American Foot and Ankle Society evaluation includes pain, function, and alignment. It shows that there was patient that gains an almost perfect result. Patient with the lowest score also had knee osteoarthritis contralateral from the operated ankle. Early weight bearing on ankle arthrodesis with cannulated screw was the major factor caused unsatisfactory result of this patient. Ankle arthrodesis with cannulated screw has satisfactory result eventhough remain complain on one patient. Nevertheless, ankle arthrodesis with cannulated screw still has an important role in the treatment of choice on ankle reconstruction.Keywords                   : Ankle arthrodesis, cannulated screw, ankle joint fusion 

scholarly journals Outcome of Ilizarov assisted ankle arthrodesis

2018 ◽  
Vol 5 (2) ◽  
pp. 433
Author(s):  
Priyajit Chattopadhyay ◽  
Paras Kumar Banka ◽  
Anindya Debnath ◽  
Sanjay Kumar
Keyword(s):  
Dynamic Compression ◽  
Weight Bearing ◽  
Major Complication ◽  
Ankle Arthrodesis ◽  
Time Interval ◽  
Early Weight Bearing ◽  
Ilizarov Fixator ◽  
American Orthopaedic ◽  
Second Procedure

Background: Among the various techniques used for ankle arthrodesis, Ilizarov technique has various advantages along with the potential for treating complex and failed cases.Methods: Eleven cases were undertaken for ankle arthrodesis using the Ilizarov fixator. Two rings were applied along the tibia and one at the talus/calcaneum. The articular cartilage was denuded, and dynamic compression applied. The clinical, functional and radiological outcome were evaluated. The goal was a stable fusion with a well aligned foot.Results: The mean follow-up period was 95 weeks. Fusion was achieved in all cases with no major complication. Only one case had a residual deformity. The average time interval for the ankle fusion was 140.8±25.7 days. The postoperative modified American Orthopaedic Foot and Ankle Society (AOFAS) Hindfoot score was 67.5±9.6 points.Conclusions: Ilizarov assisted ankle arthrodesis aids in early weight bearing, better alignment, and has good functional outcomes even in cases with previously failed procedures. It has the advantage of postoperative readjustment of the arthrodesis without the need of any second procedure with no major complications.

scholarly journals Effect of Weight-Bearing in Conservative and Operative Management of Fractures of the Base of the Fifth Metatarsal Bone

2017 ◽  
Vol 2017 ◽  
pp. 1-6 ◽  
Author(s):  
Jae-Yong Park ◽  
Hyong-Nyun Kim ◽  
Yoon-Suk Hyun ◽  
Jun-Sik Park ◽  
Hwan-Jin Kwon ◽  
...  
Keyword(s):  
Bone Resorption ◽  
Weight Bearing ◽  
Operative Management ◽  
Foot And Ankle ◽  
Early Weight Bearing ◽  
Group A ◽  
Vas Scores ◽  
American Orthopaedic ◽  
Group B ◽  
Underlying Diseases

Background. There is no established principle regarding weight-bearing in conservative and operative management of fifth metatarsal base fractures. Methods. We reviewed 86 patients with acute fifth metatarsal base fractures. Conservatively treated late or early weight-bearing patients were assigned to Group A or C, respectively. Operatively treated late or early weight-bearing patients were assigned to Group B or D, respectively. Results were evaluated by clinical union, bone resorption, and the American Orthopaedic Foot and Ankle Society (AOFAS) and Visual Analogue Scale (VAS) scores. Results. All 4 groups had bone union at a mean of 6.9 weeks (range, 5.1–15.0). There were no differences between the groups in the AOFAS and VAS scores. In the early weight-bearing groups, there were fewer cases of bone resorption, and the bone unions periods were earlier. Conclusions. Early weight-bearing may help this patient population. Moreover, conservative treatment could be an option in patients with underlying diseases.

scholarly journals Total Ankle Replacement for Treatment of End-Stage Osteoarthritis in Elderly Patients

2012 ◽  
Vol 2012 ◽  
pp. 1-8 ◽  
Author(s):  
Beat Hintermann ◽  
Markus Knupp ◽  
Lukas Zwicky ◽  
Alexej Barg
Keyword(s):  
Elderly Patients ◽  
Weight Bearing ◽  
Ankle Arthrodesis ◽  
Total Ankle Replacement ◽  
Long Term Results ◽  
Postoperative Rehabilitation ◽  
Early Weight Bearing ◽  
Ankle Replacement ◽  
First Choice ◽  
End Stage

End-stage osteoarthritis of the ankle is a disabling problem, particularly in elderly patients who experience an overall loss of mobility and functional impairment and who then need compensatory adaption. Ankle arthrodesis, which has been demonstrated to provide postoperative pain relief and hindfoot stability, leaves the patient with a stiff foot and gait changes. For elderly patient, these changes may be more critical than generally believed. Additionally, the long duration of healing and rehabilitation process needed for ankle arthrodesis may be problematic in the elderly. In contrast to ankle arthrodesis, total ankle replacement has significant advantages including a less strenuous postoperative rehabilitation and preservation of ankle motion which supports physiological gait. Recently, total ankle replacement has evolved as a safe surgical treatment in patients with end-stage ankle osteoarthritis with reliable mid- to long-term results. Total ankle replacement needs less immobilization than arthrodesis and does allow for early weight-bearing and should be considered as a treatment option of first choice in many elderly patients with end-stage osteoarthritis of the ankle, especially in elderly patients with lower expectations and physical demands.

Arthrodesis of Neuropathic Ankle Joint by Ilizarov Fixator in Diabetic Patients

2009 ◽  
Vol 99 (1) ◽  
pp. 42-48 ◽  
Author(s):  
Hasan Karapinar ◽  
Muhittin Sener ◽  
Cemal Kazimoglu ◽  
Ulas Akgun
Keyword(s):  
Ankle Joint ◽  
Effective Means ◽  
Major Complication ◽  
Ankle Arthrodesis ◽  
Ilizarov Method ◽  
Diabetic Patients ◽  
Neuropathic Arthropathy ◽  
Ilizarov Apparatus ◽  
Solid Fusion ◽  
Ilizarov Fixator

Background: Fusion of the neuropathic ankle joint is extremely difficult and associated with many complications. The use of the Ilizarov fixator in ankle fusion for patients with neuropathic arthropathy is not clear. We aimed to evaluate the results of the Ilizarov method for ankle arthrodesis in diabetic patients with neuropathic arthropathy. Methods: We report the results of neuropathic ankle joint arthrodesis performed with the Ilizarov apparatus in 11 patients. The mean age of the patients was 51 years (range, 35–67 years), all patients were diabetic, and they all had a history of ankle trauma unresponsive to conservative treatment. Deformity and instability of the ankle resulting in a nonplantigrade foot was the operative indication. Results: Solid fusion was obtained in all patients except one, at an average of 16.1 weeks (range, 12–20 weeks). At final follow-up, excellent results were obtained in three patients, good in six, fair in one, and poor in one. No major complication occured. Conclusions: The Ilizarov fixator may be an alternative and effective means for neuropathic ankle arthrodesis, especially when the usage of internal fixation methods have some limitations. (J Am Podiatr Med Assoc 99(1): 42–48, 2009)

Acute Management of Major Trauma Involving the Foot and Ankle with Hoffmann External Fixation

Foot & Ankle ◽  
1981 ◽  
Vol 1 (6) ◽  
pp. 348-361 ◽  
Author(s):  
John E. Kenzora ◽  
Charles C. Edwards ◽  
Bruce D. Browner ◽  
James G. Gamble ◽  
Jivaka B. DeSilva
Keyword(s):  
External Fixation ◽  
Open Fracture ◽  
Major Trauma ◽  
Ankle Arthrodesis ◽  
Easy Access ◽  
Acute Management ◽  
Foot And Ankle ◽  
Fracture Dislocations ◽  
Tract Infections

Massive trauma involving the foot was treated by external fixation in 33 cases and followed for 1 to 3 years. Amputations were performed in seven (21%) because of uncontrollable deep sepsis in two and massive injury in five. The other 26 (79%) had functionally acceptable feet at follow-up, but all had some stiffness and cosmetic deformity. Complications attributed to the Hoffman external fixation were limited to three pin tract infections. We recommend Hoffmann external fixation when it is necessary to: 1) stabilize major open fracture dislocations; 2) maintain length where bone is lost or extensively comminuted; 3) prevent soft tissue contractures; 4) control joint position for delayed ankle arthrodesis; and 5) provide easy access for soft and bone tissue reconstructions.

Closed arthrodesis in infected neuropathic ankles using Ilizarov ring fixation

2020 ◽  
Vol 102-B (4) ◽  
pp. 470-477 ◽  
Author(s):  
Yaser Alammar ◽  
Anatoliy Sudnitsyn ◽  
Andrey Neretin ◽  
Sergey Leonchuk ◽  
Nikolay Mikhailovich Kliushin
Keyword(s):  
Operating Time ◽  
Deformity Correction ◽  
Ankle Arthrodesis ◽  
Ilizarov Method ◽  
Foot And Ankle ◽  
Ring Fixator ◽  
Ilizarov Ring Fixator ◽  
Group A ◽  
American Orthopaedic ◽  
Group B

Aims Infected and deformed neuropathic feet and ankles are serious challenges for surgical management. In this study we present our experience in performing ankle arthrodesis in a closed manner, without surgical preparation of the joint surfaces by cartilaginous debridement, but instead using an Ilizarov ring fixator (IRF) for deformity correction and facilitating fusion, in arthritic neuropathic ankles with associated osteomyelitis. Methods We retrospectively reviewed all the patients who underwent closed ankle arthrodesis (CAA) in Ilizarov Scientific Centre from 2013 to 2018 (Group A) and compared them with a similar group of patients (Group B) who underwent open ankle arthrodesis (OAA). We then divided the neuropathic patients into three arthritic subgroups: Charcot joint, Charcot-Maire-Tooth disease, and post-traumatic arthritis. All arthrodeses were performed by using an Ilizarov ring fixator. All patients were followed up clinically and radiologically for a minimum of 12 months to assess union and function. Results The union rate for Group A was 81% (17/21) while it was 84.6% (33/39) for Group B. All the nonunions in Group A underwent revision with an open technique and achieved 100% union. Mean duration of IRF was 71.5 days (59 to 82) in Group A and 69 days (64.8 to 77.7) in Group B. The American Orthopaedic Foot and Ankle Society (AOFAS) hindfoot score was similar in both groups. The postoperative hospital stay was shorter in Group A (21 days (SD 8)) than Group B (28 days (SD 9)). In the latter Group there were more problems with wound healing and greater requirement for antibiotic treatment. The mean operating time was 40 minutes (SD 9) in Group A compared to 80 minutes (SD 13) in Group B. Recurrence of infection occurred in 19% (4/21) and 15.5% (6/39) for Group A and Group B respectively. Conclusion We found CAA using an IRF to be an effective method for ankle arthrodesis in infected neuropathic foot and ankle cases and afforded comparable results to open methods. Due to its great advantages, Ilizarov method of CAA should always be considered for neuropathic ankles in suitable patients. Cite this article: Bone Joint J 2020;102-B(4):470–477.

scholarly journals Evaluation of Results of Ilizarov Fixator and Methodology in Tibial Non- Union

2019 ◽  
Vol 15 (2) ◽  
pp. 98-102
Author(s):  
Jayabrata Ghosh ◽  
Prashanta Kumar Pujari
Keyword(s):  
Weight Bearing ◽  
Functional Results ◽  
Bone Transport ◽  
Functional Score ◽  
Early Weight Bearing ◽  
Non Union ◽  
Joint Mobilization ◽  
Formidable Challenge ◽  
Ilizarov Fixator ◽  
Hospital Study

Background: Treatment of non-union of tibial diaphyseal fractures has always posed a formidable challenge to surgeons. Persistant infection, deformity, bone loss, stiffness of joints and disability complicate the problem further. Ilizarov methodology tackles all the above problems simultaneously and offers a solution for non-union. Progressive new bone formation and increased vascularity following corticotomy and bone transport helps in filling bone gaps and promoting fracture union. Stability of the fixation allows early weight bearing, ambulation and joint mobilization. To evaluate the results of Ilizarov fixator in treating tibial non-union. Methods: This retrospective hospital study was conducted at Ramakrishna Mission Seva Pratishthan, Kolkata, India from August 2009 to February 2012. Forty two patients treated at this hospital between August 1994 and August 2011 with a minimum of 12 months follow up were included. The results were analysed on the outcome of bone and functional score using the Association for the Study and Applica-tion of the Method of Ilizarov (ASAMI) scoring system. Results: Of the 42 patients in this study, there were 28 (66.7%) excellent, 6 (14.3%) good, 5 (11.9%) fair and 3(7.1%) poor bone results and 17(40.5%) excellent, 20(47.6%) good, 2(4.8%) fair and 3(7.1%) poor functional results. Conclusions: Treatment of tibial non-unions with Ilizarov fixator is effective but not without considerable amount of complications and morbidity associated with it. The functional outcome was largely multifactorial and dependent on the final joint function, soft tissue condition and ability of the patient to return to activity.

Early Weight Bearing Ambulation after Arthroscopic Ankle Arthrodesis

2014 ◽  
Vol 18 (4) ◽  
pp. 183
Author(s):  
Yoon-Chung Kim ◽  
Sung-Wook Cho ◽  
Jin-Wha Chung
Keyword(s):  
Weight Bearing ◽  
Ankle Arthrodesis ◽  
Early Weight Bearing

Study on Outcome of Complex Lower Limb Problems treated by Ring External Fixator and Evolvement of Practices toward its Acceptability

2017 ◽  
Vol 3 (2) ◽  
pp. 35-40
Author(s):  
Sandeep Shrivastava ◽  
Sohael M Khan ◽  
Romil Rathi ◽  
Gaurav Mundada ◽  
Pradeep K Singh ◽  
...  
Keyword(s):  
External Fixator ◽  
Lower Limb ◽  
Rural Population ◽  
Age Groups ◽  
Limb Lengthening ◽  
Lower Limbs ◽  
Ilizarov Method ◽  
Cross Sectional ◽  
Ilizarov Fixator ◽  
Ring External Fixator

ABSTRACT Introduction In the developing world, there is still lack of accessibility and availability of adequate health care. In rural population this further gets limited, due to meager immediate resource at disposition and lack of availability of transports to adequate set ups. This cross-sectional study is undertaken among our rural patients who had undergone this treatment to understand what difficulties they had faced during such treatments and their acceptability toward such treatment. This study was undertaken with the aim to find out the acceptability and adaptability among the rural population for Ilizarov ring fixators. Materials and methods The study consisted of 88 consecutive cases (91 lower limbs) of all age groups, who completed the treatment by Ilizarov methodology between July 2005 and July 2012. A retrospective analysis of the procedure was done through the medical records in terms of preoperative, intra­operative, and after the complete treatment. These were analyzed for limb lengthening in centimeters, correction of deformities, total wearing duration, and final outcome. Subsequently, these patients/parents were interviewed with a questionnaire to assess the self-accessibility (ease) toward self-care; self-distraction; self-adaptability–comfort during wearing time and the difficulties faced. Results Overall the functional outcome was excellent in 18, good in 50, fair in 8, and poor in 4. Out of 91 patients, 67 (73.6%) followed up and could be evaluated for adaptability toward Ilizarov fixator. Overall, 91.04% were satisfied with the treatment by Ilizarov fixator. In the remaining the main reason for not accepting the Ilizarov method was difficulty in commuting in the public transport, ugly and threatening looks of fixator with so many wires crossing the leg. Conclusion Ilizarov method is a very effective tool for manag­ing the complex lower limb problems, especially among the population with low resources. It will ensure delivery of a very low-cost solution offered to the needy patients, wherein otherwise due to multiplicity of problems, integral solution is difficult to achieve within their resources. How to cite this article Shrivastava S, Khan SM, Rathi R, Mundada G, Singh PK, Taywade S. Study on Outcome of Complex Lower Limb Problems treated by Ring External Fixator and Evolvement of Practices toward its Acceptability. J Med Sci 2017;3(2):35-40.

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