Ilizarov External Fixator Versus Retrograde Intramedullary Nailing for Ankle Joint Arthrodesis in Diabetic Charcot Neuroarthropathy

El-Alfy, Barakat; Ali, Ayman; Fawzy, Sallam I.

doi:10.1053/j.jfas.2016.10.014

Cited by 32 publications

(32 citation statements)

References 21 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Ilizarov fixator has been regarded as a last resort for limb salvage in these cases 15 . The greater union rate in the Ilizarov technique might be related to the stability of the ring fixator and its ability to produce compression at the fusion site and stimulating bone healing 16 . Ilizarov technique addresses all three objectives of any joint arthrodesis which are successful union without deformity, stability during the fusion process through compression across the joint and elimination of instability 17 .…”

Section: Discussionmentioning

confidence: 99%

“…Charcot arthropathy is joint destructive process that leads to ankle instability, foot deformity, infection and amputation. The aim of treatment is to restore alignment and stability and achieve a plantigrade foot that is free of ulcers 16 . Arthrodesis can achieve these goals but surgical arthrodesis in Charcot neuroarthropathy has a high failure rate 16 .…”

Section: Discussionmentioning

confidence: 99%

“…The aim of treatment is to restore alignment and stability and achieve a plantigrade foot that is free of ulcers 16 . Arthrodesis can achieve these goals but surgical arthrodesis in Charcot neuroarthropathy has a high failure rate 16 . Because of infection, softening of bone and bone resorption, open reduction and internal fixation is associated with high complication rate.…”

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Ankle Arthrodesis using Ilizarov Ring Fixator: A Primary or Salvage Procedure? An Analysis of Twenty Cases

et al. 2018

View full text Add to dashboard Cite

Introduction: Ankle arthrodesis using the Ilizarov technique provides high union rate with the added benefits of early weight-bearing, and the unique advantage of its ability to promote regeneration of soft tissue around the bone, including skin, muscle and neuro-vascular structures, and its versatility to allow correction of the position of the foot by adjusting the frame post-operatively as needed. We describe our experience with this technique and the functional outcomes in our patients.Materials and Methods: This retrospective study was conducted in 20 ankle fusion cases using the Ilizarov method between the years 2007 and 2017. We defined success in treatment by loss of preoperative symptoms and radiological union on plain radiographs of the ankle.Results: Fusion was achieved in all patients (100%). Immediate post-operative ambulation was with full weight bearing (FWB) in 16 (83%) of the participants and non-weight bearing (NWB) in 3 patients (17%). Post-procedure 11 patients (67%) of the participants who were full weight bearing required some form of support for walking for 2-3 weeks. Post-operatively three patients had pin tract infection requiring intravenous antibiotics. Radiological union took range of 6-12 weeks, mean union time was 8 weeks. Only one patient required bone grafting due to bone loss. Average follow-up period was 10-45 months.Conclusion: The Ilizarov technique has a high union rate and leads to general favourable clinical outcome and may be considered for any ankle arthrodesis but is especially useful in complex cases such as for revisions, soft-tissue compromise, infection and in patients with risk for non-union. Early weight bearing is an extra benefit.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Ankle Arthrodesis using Ilizarov Ring Fixator: A Primary or Salvage Procedure? An Analysis of Twenty Cases

et al. 2018

View full text Add to dashboard Cite

show abstract

“…Shah and De 16 Ettinger et al 15 ElAlfy et al 9 Richman et al 7 Were the groups comparable other than the presence of disease in cases or the absence of disease in controls? than that following EF.…”

Section: Checklistmentioning

confidence: 99%

“…7,8 Fusion is usually the surgical treatment which is indicated in severe, progressive, unstable deformity of the hindfoot. 9 The aims of the arthrodesis reconstructive procedure are realignment and stabilization of the severely deformed ankle in order to avoid ulcers and amputation. Retrograde intramedullary nails (IMN) and ring external fixators (EFs) are two of the most common fixation techniques used for arthrodesis in CNO.…”

Section: Introductionmentioning

confidence: 99%

Intramedullary nail versus external fixator for ankle arthrodesis in Charcot neuroarthropathy: A meta-analysis of comparative studies

Yammine

Assi

2019

J Orthop Surg (Hong Kong)

View full text Add to dashboard Cite

Purpose: Ankle Charcot neuroarthropathy presents a great challenge for treatment. While conservative treatments yield poor results, arthrodesis is considered the treatment of choice for unstable Charcot ankles. There are two methods used for ankle fusion: retrograde intramedullary nail (IMN) and external fixator (EF). Literature reports inconclusive results on which method is better for arthrodesis. Methods: The aim of this meta-analysis is to look for significant difference between the two techniques in terms of fusion rate and complications. Four comparative studies including 117 patients (117 interventions) were located and analyzed. Results: IMN was found to yield double fusion rate than EF (p ¼ 0.2) with 5 weeks less time to heal (p ¼ 0.4). While no significance was noted for revision surgery and amputation rates, EF yielded higher rates of hardware infection (p ¼ 0.01) and wound infection (p ¼ 0.01). The IMN method seems to offer quicker and better fusion rate when compared to EF with significantly lower postoperative infection rates. Conclusion: In the clinical context of high-risk patients such as the diabetic population, IMN technique could be a better option in the case of ulcer-free ankles/feet or in the presence of medial/lateral ulcers. In case of presence of plantar ulcers, EF might be a better choice to avoid the plantar approach for nail insertion. Future research with bigger sample sized and randomized studies are warranted for validation.

show abstract

Surgical Reconstruction of the Charcot Foot

Liu

Raspovic

Wukich

2020

The Foot in Diabetes

View full text Add to dashboard Cite

Ilizarov External Fixator Versus Retrograde Intramedullary Nailing for Ankle Joint Arthrodesis in Diabetic Charcot Neuroarthropathy

Cited by 32 publications

References 21 publications

Ankle Arthrodesis using Ilizarov Ring Fixator: A Primary or Salvage Procedure? An Analysis of Twenty Cases

Ankle Arthrodesis using Ilizarov Ring Fixator: A Primary or Salvage Procedure? An Analysis of Twenty Cases

Intramedullary nail versus external fixator for ankle arthrodesis in Charcot neuroarthropathy: A meta-analysis of comparative studies

Surgical Reconstruction of the Charcot Foot

Contact Info

Product

Resources

About