Journal Home > Volume 9 , Issue 4
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.


menu
Abstract
Full text
Outline
About this article

The Ilizarov technique in treating denervated ankle-foot deformities

Show Author's information Dong Wang1,2Jun-Jun Shi2Le Zhang1Ying-Wei Jia2Hu-Yun Qiao2Hong Liu2Bao-Na Wang2Jian-Cheng Zang3Si-He Qin4Yong-Hong Zhang2( )
Shanxi Medical University, Taiyuan 030001, Shanxi, China
The Second Hospital of Shanxi Medical University, Taiyuan 030001, Shanxi, China
School of Population Medicine and Public Health, Chinese Academy of Medical Sciences/Peking Union Medical College, Beijing 100730, China
Rehabilitation Hospital Affiliated to National Reserach Center for Rehabilitation Technical Aids, Beijing 100176, China

Abstract

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.

Keywords:

Ilizarov technique, denervated ankle-foot deformities, external ring fixator
Received: 06 September 2021 Revised: 23 November 2021 Accepted: 26 November 2021 Published: 04 January 2022 Issue date: December 2021
References(18)
[1]
Zang JC, Qin SH, Vigneshwaran P, et al. The treatment of neurotrophic foot and ankle deformity of spinal bifida: 248 cases in single center. J Neurorestoratol 2019, 7(3): 153-160.
[2]
Ilizarov GA. The tension-stress effect on the genesis and growth of tissues: Part II. The influence of the rate and frequency of distraction. Clin Orthop Relat Res 1989, 239(239): 263-285.
[3]
Ilizarov GA. The tension-stress effect on the genesis and growth of tissues. Clin Orthop Relat Res 1989, 238: 249-281.
[4]
Kong LC, Li HA, Kang QL, et al. An update to the advances in understanding distraction histogenesis: From biological mechanisms to novel clinical applications. J Orthop Transl 2020, 25: 3-10.
[5]
Stogov MV, Luneva SN, Novikov KI. Growth factors in human serum during operative tibial lengthening with the Ilizarov method. J Orthop Res 2013, 31(12): 1966-1970.
[6]
Xia HT. Practical Guides for Bone External Fixation Technology. Beijing, China: People’s Medical Publishing House, 2013.
[7]
Qin SH, Ge JZ, Guo BF. Clinical analysis of 107 patients with foot and ankle deformities caused by spinal bifida (in Chinese). Chin J Surg 2010, 48(12): 900-903.
[8]
Zhang Y, Han ZF, Qi X. Treatment of foot deformities caused by cerebral palsy combined with recessive spinal bifida (in Chinese). Med J Chin People Health 2006, 18(15): 652-654.
[9]
Zwipp H, Sabauri G, Amlang M. Surgical management of talipes equinovarus as sequelae of a compartment and/or postischemic syndrome of the deep flexor compartment of the lower leg. Unfallchirurg 2008, 111(10): 785-795.
[10]
Lei W, Huang YT. Surgical treatment of strephenopodia (in Chinese). Chin J Pediatr Surg 1998, 19(5): 301.
[11]
Qin SH. Pediatric Orthopedics. Beijing, China: Peking University Medical Press, 2007.
[12]
Qin SH, Ge JZ, Guo BF. The originate and Chinese expression of “distractionosteogenesis” and “distractionhistogenesis” (in Chinese). Chin J Surg 2012, 50(5): 461.
[13]
Wang B, Li J, Zhang Yh, et al. Preliminary study of superb microvascular imaging monitoring angiogenesis in tibial transverse transport (in Chinese). Chin J Orthopaed 2021, 41(11): 677-686.
[14]
Malavia V, Kontogiorgos E, Elsalanty ME, et al. Nerve and vascular regeneration in bone transport osteogenesis. FASEB J 2010, 24: 181.5-181.5.
[15]
Mammoto A, Connor KM, Mammoto T, et al. A mechanosensitive transcriptional mechanism that controls angiogenesis. Nature 2009, 457(7233): 1103-1108.
[16]
Barker KL, Lamb SE, Simpson AH. Functional recovery in patients with nonunion treated with the Ilizarov technique. J Bone Joint Surg Br 2004, 86(1): 81-85.
[17]
Qin SH. External fixation and limb reconstruction: a new discipline in line with ecological medicine (in Chinese). Med Philos 2014, 35(10B):7.
[18]
Xia HT, Qin SH, Li G. Modern external fixation concepts and principles (in Chinese). Orthoped J Chin 2013, 21(10): 955-956.
Publication history
Copyright
Rights and permissions

Publication history

Received: 06 September 2021
Revised: 23 November 2021
Accepted: 26 November 2021
Published: 04 January 2022
Issue date: December 2021

Copyright

© The authors 2021

Rights and permissions

This article is published with open access at http://jnr.tsinghuajournals.com

Return