Radiological evaluation of ankle arthrodesis with Ilizarov fixation compared to internal fixation |
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| Institution: | 1. Orthopaedic and Trauma Surgery Department, Hospital Consorci Sanitari Integral, Sant Joan Despí, Barcelona, Catalonia Spain;2. Department of Experimental and Health Sciences, Faculty of Health and Life Sciences, Universitat Pompeu Fabra, Barcelona, Catalonia, Spain;1. Center for Clinical Epidemiology and Population Health, Marshfield Clinic Research Foundation, United States;2. National Farm Medicine Center, Marshfield Clinic Research Foundation, United States;3. Division of Research, Essentia Institute of Rural Health, United States;4. Department of Medicine and Public Health, University of Washington and Veterans Administration Puget Sound Health Care System, United States;1. Leibniz Universität Hannover, Institute of Mechatronic Systems, 30167 Hannover, Germany;2. Trauma Department, Hannover Medical School, 30625 Hannover, Germany;1. UNC –Project Malawi, Lilongwe, Malawi;2. University of Louisville School of Medicine, Louisville, KY, United States;3. Department of Surgery, University of North Carolina, Chapel Hill, NC, United States;4. Department of Surgery, Kamuzu Central Hospital, Lilongwe, Malawi;5. Department of Neurosurgery, University of North Carolina, Chapel Hill, NC, United States;1. Department of Orthopaedic Surgery, The Affiliated Southeast Hospital of Xiamen University, Zhangzhou, China;2. Experimental Surgery and Regenerative Medicine, Department of Surgery, Ludwig Maximilians University, Munich, Germany |
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| Abstract: | IntroductionWe asked whether the type of ankle joint arthrodesis stabilization will affect: (1) rate of union, (2) rate of adjacted-joint arthritis, (3) malalignment of the ankle joint.Material and methodsWe retrospectively radiological studied 62 patients who underwent ankle arthrodesis with Ilizarov external fixator stabilization (group 1,n = 29) or internal stabilization (group 2,n = 33) from 2006 to 2015. Radiologic outcomes were mesure by: (1) rate of union, (2) rate of adjacent-joint arthritis, (3) malalignment of the ankle joint. The Levene’s test,Mann–Whitney U test and Students t-test were used to the statistical analyses.ResultsAnkle fusion was achieved in 100% of patients treated with external fixation and in 88% with internal stabilization. Desired frontal plane alignment was achieved in 100% of patients with external fixation and 76% with internal stabilization. Desired sagittal plane alignment was achieved in 100% of external fixation and 85% of internal stabilization. A total of 14 (48.3%) patients from group 1 showed a radiographic evidence of pre-existing adjacent-joint OA. The radiographic evidence of pre-existing adjacent-joint OA was also found in 27(81.8%) subjects from group 2. Alterations of adjacent joints were also found on postoperative radiograms of 19 (65.5%) patients subjected to Ilizarov fixation and in all 33 patients from group 2.DiscusionIlizarov fixation of ankle arthrodesis is associated with lower prevalence of adjacent-joint OA and ankle joint misalignment,and with higher fusion rates than after internal fixation.Although achieving a complex ankle fusion is generally challenging,radiological outcomes after fixation with the Ilizarov apparatus are better than after internal stabilization. |
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| Keywords: | Radiological Ankle arthrodesis Ilizarov fixation Internal fixation Union Adjacted-joint arthritis Malalignment |
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