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Arthrodesis of Neuropathic Ankle Joint by Ilizarov Fixator in Diabetic Patients

Hasan Karapinar, MD ^*, Muhittin Sener, MD , Cemal Kazimoglu, MD  and Ulas Akgun, MD 

^* Department of Orthopaedics and Traumatology, Izmir Ataturk Training and Research Hospital, Izmir, Turkey.
Department of First Orthopaedic Surgery, Izmir Ataturk Training and Research Hospital, Konak, Izmir, Turkey.

Corresponding author: Hasan Karapinar, MD, Izmir Ataturk Training and Research Hospital, Mavisehir 56/5, Karsiyaka, 5700 Izmir, Turkey. (E-mail: karapinar{at}yahoo.com)

Abstract

Background: Fusion of the neuropathic ankle joint is extremely difficult and associated with many complications. The use of the Ilizarov fixator in ankle fusion for patients with neuropathic arthropathy is not clear. We aimed to evaluate the results of the Ilizarov method for ankle arthrodesis in diabetic patients with neuropathic arthropathy.

Methods: We report the results of neuropathic ankle joint arthrodesis performed with the Ilizarov apparatus in 11 patients. The mean age of the patients was 51 years (range, 35–67 years), all patients were diabetic, and they all had a history of ankle trauma unresponsive to conservative treatment. Deformity and instability of the ankle resulting in a nonplantigrade foot was the operative indication.

Results: Solid fusion was obtained in all patients except one, at an average of 16.1 weeks (range, 12–20 weeks). At final follow-up, excellent results were obtained in three patients, good in six, fair in one, and poor in one. No major complication occured.

Conclusions: The Ilizarov fixator may be an alternative and effective means for neuropathic ankle arthrodesis, especially when the usage of internal fixation methods have some limitations. (J Am Podiatr Med Assoc 99(1): 42–48, 2009)