The use of circular wire external fixation in the treatment of salvage ankle arthrodesis

Complex Ankle Arthrodesis Using the Ilizarov Method Yields High Rate of Fusion

“…Ankle fusion using circular fixation has been regarded as a last resort, limb-salvage procedure [3,5,6,8,10,11,14,16,17,20,21,23,25,[28][29][30][31] (Table 5). We asked whether (1) smoking and other comorbidities (Charcot neuroarthropathy, Type B hosts), (2) time wearing the frame, or (3) tibial lengthening affected union rate after ankle arthrodesis surgery?…”

“…Although not shown in the literature, performing a tibial osteotomy in the setting of an ankle fusion has been thought to enhance healing at the arthrodesis site [19]. The Ilizarov method [19] has been used in these complex cases [3,5,6,8,10,11,14,16,17,20,21,23,25,[28][29][30][31]. An improved understanding of the contributions of each complex variable (smoking, diabetes, Charcot neuroarthropathy, osteomyelitis, time wearing the external fixator, limb length discrepancy [LLD], and tibial lengthening) to the healing of ankle fusions would be valuable to provide information for patients' and surgeons'.…”

Tibiocalcaneal Arthrodesis With a Porous Tantalum Spacer and Locked Intramedullary Nail for Post-Traumatic Global Avascular Necrosis of the Talus

“…Perlman and Thordarson (8) studied 67 ankle fusions performed to address post-traumatic arthritis and reported a 28% nonunion rate, with trend toward significance in those who smoked, abused alcohol, abused illicit drugs, those with diabetes, and those with psychiatric disorders. Zarutsky et al (9) conducted a study on the use of circular wire external fixation in the treatment of salvage ankle arthrodesis and reported a 51.2% major complication rate, with 17.7% of the patients developing unstable nonunion and 9.8% stable pseudoarthrosis after initial salvage surgery. In addition, Cobb et al (10) reported that although the actual risk of nonunion after ankle fusion could not be established in their study, the relative risk was approximately 4 times greater for the patients who were smokers at surgery.…”

Treatment of ankle osteoarthritis: arthrodesis versus total ankle replacement

“…Drawbacks are the high rates of pin track infections and poor patient comfort, but in these complicated situations, viable limb-saving alternatives are scarce. Reports on the outcomes of the Ilizarov ring or comparable external fixation techniques for ankle fusion are rare, with the ones available accounting for fusion rates between 80 and 100% [60][61][62][63][64][65].…”