title: Outcome of transfibular ankle arthrodesis with Ilizarov apparatus.
abstract: BACKGROUND
  Both transfibular ankle arthrodesis with fibular onlay grafting and ankle arthrodesis using the Ilizarov apparatus have resulted in acceptable fusion rates. This study analyzed outcomes in the authors' practice for all patients who underwent transfibular ankle arthrodesis with fibular onlay grafting using the Ilizarov apparatus.
  
  
  METHODS
  A retrospective review was conducted of all patients who experienced severe ankle pain associated with osteoarthritis, rheumatoid arthritis, talar osteonecrosis, or septic arthritis and underwent transfibular ankle arthrodesis with an Ilizarov apparatus between 1995 and 2010. Postoperative clinical outcomes were evaluated for 42 consecutive patients (43 feet) who received primary or revision ankle arthrodesis using the Ilizarov technique at two centers. Mean duration of follow-up was 4.1 (range, 1.5 to 13) years. Outcomes were assessed using the ankle-hindfoot scale of the American Orthopaedic Foot and Ankle Society.
  
  
  RESULTS
  All ankles fused successfully. Mean clinical outcome improved significantly from 36.2 (range, 8 to 64) preoperatively to 77.4 (range, 0 to 86; p < .05) postoperatively.
  
  
  CONCLUSIONS
  Transfibular ankle arthrodesis using the Ilizarov external fixation system and fibular onlay strut grafting can achieve a very high rate of bony union and lead to general improvements in clinical outcome. Forefoot stabilization with a forefoot ring achieved rigid stabilization resulting in a shorter duration of external fixation.
authors.affiliation: Department of Orthopaedic Surgery, Hokkaido University Graduate School of Medicine, Sapporo, Hokkaido, Japan. tomozou@med.hokudai.ac.jp
authors.forename: Tomohiro
authors.initials: T
authors.lastname: Onodera
authors.forename: Tokifumi
authors.initials: T
authors.lastname: Majima
authors.forename: Yasuhiko
authors.initials: Y
authors.lastname: Kasahara
authors.forename: Daisuke
authors.initials: D
authors.lastname: Takahashi
authors.forename: Shuji
authors.initials: S
authors.lastname: Yamazaki
authors.forename: Ryo
authors.initials: R
authors.lastname: Ando
authors.forename: Akio
authors.initials: A
authors.lastname: Minami
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000843:Ankle Joint / Q000601:surgery*; D001168:Arthritis / Q000601:surgery; D001174:Arthrodesis / Q000379:methods*; D005260:Female; D005360:Fibula / Q000601:surgery; D005500:Follow-Up Studies; D006801:Humans; D007085:Ilium / Q000637:transplantation; D018889:Ilizarov Technique; D008297:Male; D008875:Middle Aged; D010020:Osteonecrosis / Q000601:surgery; D010027:Osteotomy; D011183:Postoperative Complications; D012189:Retrospective Studies; D055815:Young Adult