TALOCRURAL ARTHRODESIS USING THE METHOD OF ILIZAROV

Abstract

Background: Talocrural arthrodesis using the method of Ilizarov is a reasonable procedure for patients with secondary ankle degenerative changes and comorbidities, making other surgical treatment impossible. The aim of this study is to evaluate the results of talocrural arthrodesis as union rate, deviations, functional restoration and complications. Patients and Methods: The study has included 26 patients with Ilizarov talocrural compressive arthrodesis at the Clinic for Orthopaedic Surgery in Skopje from 2015 to 2019, of which 3 were with simultaneous gradual distraction. The follow up was from 22 to 64 months. The age varied from 41 to 77 years. All patients were with comorbidities and poor bone and soft tissue condition. The monitoring was performed using native radiography and ultrasonography at the compression/distraction site. Results: A complete bone fusion was achieved in all patients. The median time of wearing the external fixator was 22 weeks. In three cases with simultaneous distraction, the average bone healing index was 47 days/cm. The final maximal length discrepancy was 11 mm. In 16 patients (61.53%) sings of pin tract infections were detected. The mean number of pin site infections was 2.3/patient. No pin infection has required a change of the pin. Once the construct was removed, patients used a cast for 4-6 weeks and a walker boot for next 6-8 weeks. Conclusion: A talocrural arthrodesis performed by the Ilizarov method offers a high union rate, few deviations and a good functional restoration, often with no additional surgical procedures. In cases with numerous comorbidities and a poor limb condition, it can be a method of choice instead of an arthrodesis using internal fixation in the treatment of end-stage ankle arthritis.