Treatment of Foot and Ankle Deformities with the Ilizarov Fixator

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

Ortopedia Traumatologia Rehabilitacja ◽

10.5604/01.3001.0012.8393 ◽

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.

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