Background:
Failed septic ankle arthrodesis is a challenging problem. This
study evaluated the results of salvage revision ankle arthrodesis
using Ilizarov external fixation to treat nonunited arthrodesis of
posttraumatic septic ankle arthritis and to analyze the functional
outcome of this method.
Methods:
This prospective study included 14 patients with a mean age of
48 yr. Patients had already undergone a mean of 4.43 previous
surgeries at a mean of 17.14mo from primary arthrodesis. Five
patients had associated deformity. The mean preoperative American
Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot
score was 23.93. Meticulous debridement was done and an Ilizarov
fixator was applied in compression in a one-stage procedure.
Results:
The mean follow up period was 41.71mo with mean external
fixation period of 17.29 wk. Successful arthrodesis in perfect
alignment was achieved in 13 of 14 patients without additional
procedures. One ankle did not go on to union. A chronic
discharging sinus persisted in one patient. One infected loose
wire was exchanged in two patients. One diabetic patient
reported moderate daily diffuse pain. The mean postoperative
AOFAS ankle-hindfoot score was 71.57. Patients with successful
fusion were satisfied with the procedure.
Conclusions:
Using an Ilizarov fixator to salvage nonunited septic posttraumatic
ankle arthrodesis was effective, with patients reporting a stable ankle
and dramatic functional improvement with minimal complication