Arthrodesis of the Ankle Joint

One of the indications for arthrodesis (joint fusion) of the ankle joint is a joint deformity, which may occur, after intra-articular fracture or post-traumatic necrosis of the talus, or due to some developmental abnormalities of the skeletal and muscular system that can cause destruction of the cartilage that covers the articular surface of the bones.

The classic method of treatment using screws and rods has many disadvantages. First of all, there is a high rate (20-30%) of failure of bone union that results in necessity of repeat surgeries. When using the Ilizarov method, this rate is ten times lower.

During the classic treatment the patients are not allowed to weight bear on the foot for two months, while, using the Ilizarov method, the patients begins to weight bear on the involved foot on the second post-operative day, which shortens significantly the bone healing period. Besides, when using the Ilizarov method, after the treatment and the apparatus removal, the affected area has no arthrodesis plates or bolts left in place. Therefore there is no need for another surgery for removing them (in case they cause discomfort to the patient).

Tibial non-union with post-traumatic osteoarthritis of the ankle joint

Patient (52 years old) was referred for consultation with diagnosed pseudarthrosis (post-fracture union failure) of the right lower third of the leg, as well as for an ankle joint deformity. Patient was complaining of severe pain. The patient uses crutches for walking.

History of present complaint: a year ago, after falling from the third floor, the patient suffered both legs fractures. She was operated at the regional hospital where the fractures were fixed with plates and screws.

I have performed ankle arthrodesis and non-union fixation using the Ilizarov apparatus.

From the second post-operative day the patient started physiotherapy exercises. She was walking with crutches, loading her injured leg. Two months later she started to walk without the crutches.

The apparatus was removed after five months. A complete fracture healing occurred as well as the arthrodesis (fusion) of the ankle joint.

The patient returned to work seven months after treatment.

At the follow-up examination 12 months post-treatment, the patient is completely satisfied with the results.

After the surgery
After the surgery