title: [Tibiotalar or tibiocalcaneal arthrodesis using the ilizarov technique in the presence of infected nonunions of ankle joints].
abstract: OBJECTIVE
  To evaluate the results of managing the infected nonunions of distal tibial fractures combined with talar fracture and calcaneal fracture with tibial bone transport, tibiotalar or tibiocalcaneal arthrodesis using the hybrid external fixator.
  
  
  METHODS
  A retrospective review of 26 patients who underwent either tibiotalar arthodesis or tibiocalcaneal arthodesis using an hybrid external fixator for infected nonunions of distal tibial fractures, talar and calcaneal fractures after tibial bone distraction was made. Each patient had a debridement of all infected and nonviable bones, the wound area were 2 cm×4 cm-4 cm×8 cm. The bony surfaces of distal tibia and talus were prepared for the fusion followed by application of an Orthofix's hybrid external fixator.
  
  
  RESULTS
  The remaining 18 patients undertook debridement at the docking sites, and 14 of them had autogenous bone grafting. There was a mean follow-up of 32 months (22-38 months). All the patients had successful fusions. There were no recurrent deep infections or amputations. Two patients had 6° of varus deformity at the docking site.
  
  
  CONCLUSIONS
  Tibiotalar or tibiocalcaneal arthrodesis using the Ilizarov technique is viable alternative to amputation in patients with infected nonunions,especially if there is a large bone loss of the tibias, talus and calcaneus.
authors.affiliation: Department of Orthotrauma, Beijing Jishuitan Hospital, Beijing 100035, China; Email: huangleijst@126.com.
authors.forename: Lei
authors.initials: L
authors.lastname: Huang
authors.forename: Shendong
authors.initials: S
authors.lastname: Wang
authors.forename: Xing
authors.initials: X
authors.lastname: Teng
authors.forename: Shengsong
authors.initials: S
authors.lastname: Yang
authors.forename: Zhilin
authors.initials: Z
authors.lastname: Xia
authors.forename: Gang
authors.initials: G
authors.lastname: Zhao
authors.forename: Tao
authors.initials: T
authors.lastname: Wang
authors.forename: Manyi
authors.initials: M
authors.lastname: Wang
mesh_terms: D000671:Amputation, Surgical; D016512:Ankle Injuries; D000843:Ankle Joint; D001174:Arthrodesis; D016025:Bone Transplantation; D002111:Calcaneus; D016267:External Fixators; D005500:Follow-Up Studies; D018409:Foot Injuries; D050723:Fractures, Bone; D006801:Humans; D018889:Ilizarov Technique; D004204:Joint Dislocations; D012189:Retrospective Studies; D013628:Talus; D013977:Tibia; D013978:Tibial Fractures