The Ilizarov technique in treating denervated ankle-foot deformities

Background:

Neurological injuries or diseases may cause ankle-foot deformities that seriously affect patients’ quality of life.

Objective:

This study aimed to explore the feasibility of the Ilizarov technique for treating complex ankle-foot deformity with neurotrophic disorders.

Methods:

In this retrospective study, 10 patients, including 6 males and 4 females, with complex ankle-foot deformities with nerve injury were treated from January 2014 to May 2019. The age of the patients ranged from 13 to 57 years with an average of 27.9 years. The reasons of nerve injury were as follows: sequelae of spina bifida in five patients, post-traumatic injury of the common peroneal nerve and tibial nerve in four patients, and subacute degeneration of the spinal cord in one patient. Minimally invasive surgery was used for osteotomy, muscle strength balance, and external ring frame fixation, and various deformities were gradually corrected after the operation. The ankle- foot function was evaluated using the American Orthopedic Foot and Ankle Society (AOFAS) Ankle-Hindfoot Score before surgery and at long-term follow-up after surgery.

Results

: All 10 patients were followed up for 12 months to 3 years, with an average of 1.9 years. The deformities of all 10 patients were corrected; and of the 10 patients, three partially recovered their nerve function. A significant difference (p < 0.001) between the AOFAS score (81.6 ± 10.45) evaluated in the long-term follow-up and that evaluated preoperatively (31.1 ± 14.69). The AOFAS comprehensive score was excellent in two patients, good in six patients, and fair in two patients.

Conclusion:

The Ilizarov technique combined with minimally invasive osteotomy and muscle strength balance could safely correct complex ankle-foot deformities with neurotrophic disorders.