ANALYSIS OF ANKLE ARTHRODESIS DUE TO TIBIOTALAR FRACTURE CAUSED BY GUN SHOT INJURY USING ILIZAROV EXTERNAL FIXATOR

Abstract

In this study, we evaluated the results of ankle arthrodesis performed with Ilizarov external fixator which was applied to 14 ankles of 14 patients who had a comminuted tibiotalar fracture as a result of stepping on a mine or a gunshot injury. Material and
Methods: Between March 1995- December 2000, tibiotalar arthrodesis was performed with Ilizarov circular external fixator on 14 ankles of 14 patients who had pain and degenerative arthritis caused by a gunshot injury. The average age of our patients was 20 (19-21) and all were male. The aim of the surgical treatment was to prevent pain and related antalgic gait in 12 patients. In 2 patients, prevention of pain as well as correction of an equinus deformity was the goal. Ilizarov external fixator was placed while the ankle was in neutral position, and 0.5-cm acute compression was applied. On the first postoperative day, 1-mm of compression was applied. This was continued for 7 days. When radiographic union was accomplished in the arthrodesis site, the frame which were used for 6 months on average were taken out. The average follow-up period was 29 (19-64) months.
Results: Radiological arthrodesis was obtained in all patients. Of all arthrodesis, 13 resulted in neutral position and 1 in 20 degrees equine position. According to our subjective assessment depending on questioning, 78.7 % success was provided. Pin tract infection in 6 patients, ring secestr in 1 patient, reflex sympathic dystrophia in 1 patient were observed as complication.
Conclusion: Ilizarov external fixator can be applied easily in contaminated areas and minimizes the union and deformity problems. Furthermore, problems in the postoperative period can also be handled with the modification of frames. For all these reasons, Ilizarov external fixator is an ideal treatment method for ankle problems caused by gunshot wounds.