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Title: [Combination Ilizarov technique with tibiotalar or tibiocalcanean arthrodesis for one-stage treatment of ankle joints infection and bone defects].
Author: Zhang L, Wang X, Chen Y, Wan M, Chen J.
Journal: Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi; 2017 Sep 15; 31(9):1059-1063. PubMed ID: 29798562.
Abstract:
OBJECTIVE: To evaluate the effectiveness of Ilizarov technique and tibiotalar or tibiocalcanean arthrodesis for one-stage treatment of ankle joints infection and bone defects. METHODS: Between January 2014 and April 2016, 14 patients with ankle joints infection and bone defects were treated by Ilizarov technique and tibiotalar or tibiocalcanean arthrodesis for one-stage. There were 12 males and 2 females with an average age of 39.8 years (range, 25-61 years). The causes of ankle infection included falling from height injury in 5 cases, falling injury in 4 cases, traffic accident injury in 1 case, crushing injury in 1 case, sprain injury in 1 case, and hematogenous reason in 2 cases. All the patients received surgery for 0-8 times (mean, 3.7 times) before admission. The modified American Orthopaedic Foot and Ankle Society (AOFAS) ankle and hindfoot score was 30.25±3.54 before operation. The disease duration was 1-30 months (mean, 10.3 months). RESULTS: All the incisions healed by first intension without recurrence of infection, and two-stage bone grafting operation did not performed. One case felt slight local pain and swell of ankle joint after weight-bearing walking more than 30 minutes, and without special treatment. All the patients had different degree skin redness and swelling of Kirschner wire pinhole for 0-3 times, and relieved after symptomatic treatment. All the patients were followed up 6-27 months (mean, 16.8 months). Except for 2 cases who did not remove the external fixator (with external fixation time of 6 months and 8 months respectively), the other patients removed the external fixator at 6-14 months (mean, 9 months) after operation, all patients recovered the walk function and without ankle pain. The modified AOFAS ankle and hindfoot score after removal of external fixator (70.92±1.0) was significantly higher than preoperative one ( t=-10.992, P=0.000). CONCLUSION: It is a simple and effective method for one-stage treatment of ankle joints infection and bone defects by Ilizarov technique and tibiotalar or tibiocalcanean arthrodesis. 目的: 探讨应用 Ilizarov 技术行胫跟或胫距跟融合同期治疗踝关节感染并骨缺损的效果。. 方法: 2014 年 1 月—2016 年 4 月，应用 Ilizarov 技术行胫跟或胫距跟融合同期治疗踝关节感染并骨缺损 14 例。其中男 12 例，女 2 例；年龄 25～61 岁，平均 39.8 岁。踝关节感染原因：外伤 12 例，其中高处坠落伤 5 例，摔伤 4 例，交通事故伤 1 例，砸伤 1 例，扭伤 1 例；血源性 2 例。入院前曾行手术 0～8 次，平均 3.7 次。术前改良美国矫形足踝协会（AOFAS）踝与后足评分为（30.25±3.54）分。病程 1～30 个月，平均 10.3 个月。. 结果: 患者术后切口均 Ⅰ 期愈合，无感染复发，均未行二期植骨融合等手术干预。1 例患者诉行走时间>30 min 后出现踝关节周围轻度疼痛及肿胀，未行特殊处理；患者术后出现 0～3 次不同程度针眼红肿情况，经相应处理后缓解。14 例均获随访，随访时间 6～27 个月，平均 16.8 个月。除 2 例尚未拆除外固定架（带架时间分别为 6、8 个月），其余患者均于术后 6～14 个月，平均 9 个月拆除外固定架，均恢复行走功能。拆架后改良 AOFAS 踝与后足评分为（70.92±1.05）分，与术前比较差异有统计学意义（ t=–10.992， P=0.000）。. 结论: 结合 Ilizarov 技术行胫跟或胫距跟融合同期治疗踝关节感染并骨缺损是一种简便有效的治疗方法。.

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