Complex ankle arthrodesis using the Ilizarov method yields high rate of fusion. Academic Article uri icon

Overview

MeSH

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Arthropathy, Neurogenic
  • Child
  • Female
  • Humans
  • Male
  • Middle Aged
  • Postoperative Complications
  • Retrospective Studies
  • Smoking
  • Treatment Outcome
  • Young Adult

MeSH Major

  • Ankle Joint
  • Arthrodesis
  • Ilizarov Technique

abstract

  • Ankle arthrodesis may be achieved using the Ilizarov method. Comorbidities, such as diabetes, Charcot neuroarthropathy, osteomyelitis, leg length discrepancy, and smoking, can make an ankle fusion complex and may be associated with lower rates of healing. We asked if (1) smoking and other comorbidities led to lower fusion rates, (2) time wearing the frame affected outcome, and (3) simultaneous tibial lengthening improved fusion rates. We retrospectively studied 101 patients who underwent complex ankle fusion using the Ilizarov technique. The median time wearing the frame was 25 weeks (range, 10-65 weeks). Twenty-four patients had simultaneous tibial lengthening. The minimum followup for 91 of the 101 patients was 27 months (median, 65 months; range, 27-134 months). Fusion was achieved in 76 of 91 patients. Smoking was associated with a 54% rate of nonunion. Fifteen of 19 patients with Charcot neuroarthropathy achieved union but had a high rate of subsequent subtalar joint failure. Time wearing the frame did not affect union rates. Tibial lengthening did not improve ankle fusion rates. Smokers should be warned of the high risk of nonunion and we recommend they quit smoking. We also recommend surgeons recognize the higher nonunion rate in patients with Charcot neuroarthropathy. We believe tibial lengthening should not be performed to enhance healing at the fusion site. Level IV, prognostic study. See the Guidelines for Authors for a complete description of levels of evidence.

publication date

  • October 2012

has subject area

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Ankle Joint
  • Arthrodesis
  • Arthropathy, Neurogenic
  • Child
  • Female
  • Humans
  • Ilizarov Technique
  • Male
  • Middle Aged
  • Postoperative Complications
  • Retrospective Studies
  • Smoking
  • Treatment Outcome
  • Young Adult

Research

keywords

  • Journal Article

Identity

Language

  • eng

PubMed Central ID

  • PMC3441986

Digital Object Identifier (DOI)

  • 10.1007/s11999-012-2470-9

PubMed ID

  • 22777590

Additional Document Info

start page

  • 2864

end page

  • 2873

volume

  • 470

number

  • 10