Clinical evaluation of ankle arthrodesis with Ilizarov fixation and internal fixation
Tóm tắt
Ankle arthrodesis may have internal or external stabilization. We assessed whether the type of stabilization after ankle arthrodesis will affect: (1) functional outcome in Foot and Ankle Ability Measure (FAAM) scale, (2) pain level, (3) period of hospitalization, (4) rate of complications. We retrospectively studied 47 individuals after ankle arthrodesis with Ilizarov fixation (group 1, n = 21) and internal stabilization (group 2, n = 26) at our institution in years 2007–2015. Clinical outcomes were measure by: (1) functional outcome in FAAM scale, (2) pain level, (3) period of hospitalization, (4) rate of complications. Total number of complications in Ilizarov group was 13, which corresponded to 0.62 complications per patient on average. In group 2 there were 15 complications, which corresponded to 0.58 complications per patient on average. The intergroup difference in rate of complications was not statistically significant (p = 0.066). In group 1 the mean VAS pain level before treatment was 4.69 and after treatment was 1.5 (p = 0.037). In group with internal stabilization the mean VAS pain level before treatment was 4.71 and after treatment was 2.9 (p = 0.044). In group 1 the mean period of hospitalization was 5.29 days, in group 2 was 5.71 days (p = 0.517). In group 1 the mean functional outcome in FAAM scale was 79.38, in group 2 was 70.11 (p = 0.458). Ankle arthrodesis with Ilizarov stabilization is associated with lower prevalence of VAS pain level after surgery than after internal screws stabilization. Rate of complications, FAAM functional score and period of hospitalization were not statistically significant between group 1 and 2. Clinical outcome was satisfactory in group 1 and 2, but outcomes in Ilizarov group were slightly better than after internal stabilization.
Tài liệu tham khảo
Fragomen AT, Borst E, Schachter L, Lyman S, Rozbruch SR. Complex ankle arthrodesis using the Ilizarov method yields high rate of fusion. Clin Orthop Relat Res. 2012;470:2864–73.
Rabinovich RV, Haleem AM, Rozbruch SR. Complex ankle arthrodesis: review of the literature. World J Orthop. 2015;6:602–13.
Siebachmeyer M, Boddu K, Bilal A, Hester TW, Hardwick T, Fox TP, et al. Outcome of one-stage correction of deformities of the ankle and hindfoot and fusion in Charcot neuroarthropathy using a retrograde intramedullary hindfoot arthrodesis nail. Bone Joint J. 2015;97-B:76–82.
Perlman MH, Thordarson DB. Ankle fusion in a high risk population: an assessment of nonunion risk factors. Foot Ankle Int. 1999;20:491–6.
Chahal J, Stephen DJ, Bulmer B, Daniels T, Kreder HJ. Factors associated with outcome after subtalar arthrodesis. J Orthop Trauma. 2006;20:555–61.
Jiang JJ, Schipper ON, Whyte N, Koh JL, Toolan BC. Comparison of perioperative complications and hospitalization outcomes after ankle arthrodesis versus total ankle arthroplasty from 2002 to 2011. Foot Ankle Int. 2015;36:360–8.
Dalat F, Trouillet F, Fessy MH, Bourdin M, Besse JL. Comparison of quality of life following total ankle arthroplasty and ankle arthrodesis: retrospective study of 54 cases. Orthop Traumatol Surg Res. 2014;100:761–6.
Tellisi N, Fragomen AT, Ilizarov S, Rozbruch SR. Limb salvage reconstruction of the ankle with fusion and simultaneous tibial lengthening using the Ilizarov/Taylor spatial frame. HSS J. 2008;4:32–42.
Katsenis D, Bhave A, Paley D, Herzenberg JE. Treatment of malunion and nonunion at the site of an ankle fusion with the Ilizarov apparatus. J Bone Joint Surg Am. 2005;87:302–9.
Onodera T, Majima T, Kasahara Y, Takahashi D, Yamazaki S, Ando R, et al. Outcome of transfibular ankle arthrodesis with Ilizarov apparatus. Foot Ankle Int. 2012;33:964–8.
Salem KH, Kinzl L, Schmelz A. Ankle arthrodesis using Ilizarov ring fixators: a review of 22 cases. Foot Ankle Int. 2006;27:764–70.
Ling JS, Smyth NA, Fraser EJ, Hogan MV, Seaworth CM, Ross KA, et al. Investigating the relationship between ankle arthrodesis and adjacent-joint arthritis in the hindfoot: a systematic review. J Bone Joint Surg Am. 2015;97:513–20.
Houdek MT, Wilke BK, Ryssman DB, Turner NS. Radiographic and functional outcomes following bilateral ankle fusions. Foot Ankle Int. 2014;35:1250–4.
Strasser NL, Turner NS. Functional outcomes after ankle arthrodesis in elderly patients. Foot Ankle Int. 2012;33:699–703.
Hendrickx RP, Stufkens SA, de Bruijn EE, Sierevelt IN, van Dijk CN, Kerkhoffs GM. Medium- to long-term outcome of ankle arthrodesis. Foot Ankle Int. 2011;32:940–7.
Slater GL, Sayres SC, O'Malley MJ. Anterior ankle arthrodesis. World J Orthop. 2014;5:1–5.
Ogut T, Glisson RR, Chuckpaiwong B, Le IL, Easley ME. External ring fixation versus screw fixation for ankle arthrodesis: a biomechanical comparison. Foot Ankle Int. 2009;30:353–60.
Martin RL, Irrgang JJ, Burdett RG, Conti SF, Van Swearingen JM. Evidence of validity for the Foot and Ankle Ability Measure (FAAM). Foot Ankle Int. 2005;26:968–83.
Bednarz P, Beal’s T, Manila A. Subtalar distraction bone blok fusion:an assessment of outcome. Foot Ankle Int. 1997;18:785–91.
Braito M, Dammerer D, Kaufmann G, Fischler S, Carollo J, Reinthaler A, et al. Are our expectations bigger than the results we achieve? A comparative study analysing potential advantages of ankle arthroplasty over arthrodesis. Int Orthop. 2014;38:1647–53.
Morasiewicz P, Dejnek M, Urbański W, Dragan SŁ, Kulej M, Dragan SF. Radiological evaluation of ankle arthrodesis with Ilizarov fixation compared to internal fixation. Injury. 2017;48:1678–83. https://doi.org/10.1016/j.injury.2017.04.013.
SooHoo NF, Zingmond DS, Ko CY. Comparison of reoperation rates following ankle arthrodesis and total ankle arthroplasty. J Bone Joint Surg Am. 2007;89:2143–9.
Hoover JR1, Santrock RD, James WC 3rd. Ankle fusion stability: a biomechanical comparison of external versus internal fixation. Orthopedics. 2011;34(4). doi: https://doi.org/10.3928/01477447-20110228-04.
Biz C, Hoxhaj B, Aldegheri R, Iacobellis C. Minimally invasive surgery for Tibiotalocalcaneal arthrodesis using a retrograde intramedullary nail: preliminary results of an innovative modified technique. J Foot Ankle Surg. 2016;55(6):1130–8. https://doi.org/10.1053/j.jfas.2016.06.002. Epub 2016 Aug 11.
Baumbach SF, Massen FK, Hörterer S, Braunstein M, Waizy H, Böcker W, Polzer H. Comparison of arthroscopic to open tibiotalocalcaneal arthrodesis in high-risk patients. Foot Ankle Surg. 2018. S1268–7731(18)30180–2. https://doi.org/10.1016/j.fas.2018.10.006. Epub ahead of print.
Griffin MJ, Coughlin MJ. Evaluation of Midterm Results of the Panta Nail: An Active Compression Tibiotalocalcaneal Arthrodesis Device. J Foot Ankle Surg. 2018;57(1):74–80. https://doi.org/10.1053/j.jfas.2017.08.010.