Tags

Type your tag names separated by a space and hit enter

Mid-term walking ability after Charcot foot reconstruction using the Ilizarov ring fixator.
Arch Orthop Trauma Surg. 2020 Dec; 140(12):1909-1917.AO

Abstract

BACKGROUND

Failed conservative treatment and complications are indications for foot reconstruction in Charcot arthropathy. External fixation using the Ilizarov principles offers a one-stage procedure for deformity correction and resection of osteomyelitic bone. The aim of this study was to determine whether external fixation with an Ilizarov ring fixator leads reliably to walking ability.

MATERIALS AND METHODS

29 patients treated with an Ilizarov ring fixator for Charcot arthropathy were retrospectively analyzed. Radiologic fusion at final follow up was assessed separately on conventional X-rays by two authors. The association between walking ability and the presence of osteomyelitis at the time of reconstruction, and the presence of fusion at final follow up was investigated using Fisher's exact test.

RESULTS

Mean follow up was 35 months (range 5.3-107) months; mean time of external fixation was 113 days. Ten patients (34.5%) reached fusion, but 19 did not (65.5%). Two patients needed below knee amputation. 26 of the remaining 27 patients maintained walking ability, 23 of those without assistive devices. Walking ability was independent from the presence of osteomyelitis at the time of reconstruction and from the presence of fusion.

CONCLUSION

Foot reconstruction with an Ilizarov ring fixator led to limb salvage in 93%. The vast majority (96.3%) of patients with successful limb salvage was ambulatory, independent from radiologic fusion, and presence of osteomyelitis at the time of reconstruction. These findings encourage limb salvage and deformity correction in this difficult-to-treat disease, even with underlying osteomyelitis.

Authors+Show Affiliations

Division of Foot and Ankle Surgery, Department of Orthopaedic Surgery, Balgrist University Hospital, Forchstrasse 340, 8008, Zurich, Switzerland.Division of Foot and Ankle Surgery, Department of Orthopaedic Surgery, Balgrist University Hospital, Forchstrasse 340, 8008, Zurich, Switzerland.Division of Foot and Ankle Surgery, Department of Orthopaedic Surgery, Balgrist University Hospital, Forchstrasse 340, 8008, Zurich, Switzerland.Division of Foot and Ankle Surgery, Department of Orthopaedic Surgery, Balgrist University Hospital, Forchstrasse 340, 8008, Zurich, Switzerland.Divison of Technical Orthopaedics, Department of Orthopaedic Surgery, Balgrist University Hospital, Forchstrasse 340, 8008, Zurich, Switzerland.Divison of Technical Orthopaedics, Department of Orthopaedic Surgery, Balgrist University Hospital, Forchstrasse 340, 8008, Zurich, Switzerland.Division of Foot and Ankle Surgery, Department of Orthopaedic Surgery, Balgrist University Hospital, Forchstrasse 340, 8008, Zurich, Switzerland. felix.waibel@balgrist.ch. Divison of Technical Orthopaedics, Department of Orthopaedic Surgery, Balgrist University Hospital, Forchstrasse 340, 8008, Zurich, Switzerland. felix.waibel@balgrist.ch.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

32170454

Citation

Wirth, Stephan H., et al. "Mid-term Walking Ability After Charcot Foot Reconstruction Using the Ilizarov Ring Fixator." Archives of Orthopaedic and Trauma Surgery, vol. 140, no. 12, 2020, pp. 1909-1917.
Wirth SH, Viehöfer AF, Tondelli T, et al. Mid-term walking ability after Charcot foot reconstruction using the Ilizarov ring fixator. Arch Orthop Trauma Surg. 2020;140(12):1909-1917.
Wirth, S. H., Viehöfer, A. F., Tondelli, T., Hartmann, R., Berli, M. C., Böni, T., & Waibel, F. W. A. (2020). Mid-term walking ability after Charcot foot reconstruction using the Ilizarov ring fixator. Archives of Orthopaedic and Trauma Surgery, 140(12), 1909-1917. https://doi.org/10.1007/s00402-020-03407-5
Wirth SH, et al. Mid-term Walking Ability After Charcot Foot Reconstruction Using the Ilizarov Ring Fixator. Arch Orthop Trauma Surg. 2020;140(12):1909-1917. PubMed PMID: 32170454.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Mid-term walking ability after Charcot foot reconstruction using the Ilizarov ring fixator. AU - Wirth,Stephan H, AU - Viehöfer,Arnd F, AU - Tondelli,Timo, AU - Hartmann,Rebecca, AU - Berli,Martin C, AU - Böni,Thomas, AU - Waibel,Felix W A, Y1 - 2020/03/13/ PY - 2019/10/06/received PY - 2020/3/15/pubmed PY - 2021/4/27/medline PY - 2020/3/15/entrez KW - Charcot arthropathy KW - External fixation KW - Ilizarov KW - One-stage reconstruction KW - Osteomyelitis SP - 1909 EP - 1917 JF - Archives of orthopaedic and trauma surgery JO - Arch Orthop Trauma Surg VL - 140 IS - 12 N2 - BACKGROUND: Failed conservative treatment and complications are indications for foot reconstruction in Charcot arthropathy. External fixation using the Ilizarov principles offers a one-stage procedure for deformity correction and resection of osteomyelitic bone. The aim of this study was to determine whether external fixation with an Ilizarov ring fixator leads reliably to walking ability. MATERIALS AND METHODS: 29 patients treated with an Ilizarov ring fixator for Charcot arthropathy were retrospectively analyzed. Radiologic fusion at final follow up was assessed separately on conventional X-rays by two authors. The association between walking ability and the presence of osteomyelitis at the time of reconstruction, and the presence of fusion at final follow up was investigated using Fisher's exact test. RESULTS: Mean follow up was 35 months (range 5.3-107) months; mean time of external fixation was 113 days. Ten patients (34.5%) reached fusion, but 19 did not (65.5%). Two patients needed below knee amputation. 26 of the remaining 27 patients maintained walking ability, 23 of those without assistive devices. Walking ability was independent from the presence of osteomyelitis at the time of reconstruction and from the presence of fusion. CONCLUSION: Foot reconstruction with an Ilizarov ring fixator led to limb salvage in 93%. The vast majority (96.3%) of patients with successful limb salvage was ambulatory, independent from radiologic fusion, and presence of osteomyelitis at the time of reconstruction. These findings encourage limb salvage and deformity correction in this difficult-to-treat disease, even with underlying osteomyelitis. SN - 1434-3916 UR - https://www.unboundmedicine.com/medline/citation/32170454/Mid_term_walking_ability_after_Charcot_foot_reconstruction_using_the_Ilizarov_ring_fixator_ L2 - https://dx.doi.org/10.1007/s00402-020-03407-5 DB - PRIME DP - Unbound Medicine ER -