Tibiocalcaneal arthrodesis using the ilizarov technique in the presence of bone loss and infection of the talus

Robert Rochman, James Jackson Hutson, Oladapo Alade

Research output: Contribution to journalArticle

35 Scopus citations

Abstract

Background: Infected nonunions and extrusions of the talus can often lead to below-knee amputation. Limb-salvage procedures have goals of eradicating infection and creating a painless, stable limb. Often, a tibiocalcaneal fusion is the best option; however, in the presence of infection and bone loss, it can be difficult to achieve a successful outcome using internal fixation. We review the results of circular ring external fixation to obtain a tibiocalcaneal arthrodesis despite these obstacles. Methods: A retrospective review of 11 patients who underwent tibiocalcaneal arthodesis using an Ilizarov external fixator for infected talar nonunions or extrusions was performed. Each patient had a debridement of all nonviable talus. The bony surfaces were prepared for the fusion followed by application of a circular ring fixator. Clinical outcomes were measured using the AOFAS ankle-hindfoot scale. There was a mean followup of 35 months. Results: Nine of the 11 patients had successful fusions. One fused successfully after a revision and the other developed a stable pseudoarthrosis. Eight patients underwent concomitant lengthening with the Ilizarov fixator. Mean AOFAS score at final followup was 65. This was out of a maximum of 86 since the tibiotalar and subtalar joint motion were removed. There were no recurrent deep infections or amputations. Conclusions: Tibiocalcaneal arthrodesis using the Ilizarov technique is a viable alternative to amputation in patients with infected nonunions or large bone loss of the talus.

Original languageEnglish (US)
Pages (from-to)1001-1008
Number of pages8
JournalFoot and Ankle International
Volume29
Issue number10
DOIs
StatePublished - Oct 1 2008
Externally publishedYes

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Keywords

  • Ilizarov external fixator
  • Limb salvage
  • Nonunion
  • Tibiocalcaneal arthrodesis

ASJC Scopus subject areas

  • Surgery
  • Orthopedics and Sports Medicine

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