The Ilizarov external fixation frame in compression arthrodesis of large, weight bearing joints

Solid bony fusion of large joints affected with active chronic infections, is still the most effective surgical solution to establish a useful function of the affected limb. Even with extensive peri-articular bone loss and severe deformities, arthrodesis in a functional position can provide effective stability. The reported fusion rates in such patients are not encouraging however, and secondary amputations have been reported. Compression arthrodesis using an Ilizarov external fixation frame was performed for 17 destroyed feet (14 tibiotalar and 3 subtalar joints) and 6 badly disrupted knees in a series of 20 patients. Evaluation of the results was based on the clinical and radiological joint alignment, achievement of fusion, presence or absence of infection, and functional outcome. One patient after knee joint arthrodesis was lost to follow-up, and two knees had developed a clinically stable fibrous union. Solid fusion was obtained in all other joints. All joints were in anatomical alignment and the patients were fully functional at the time of review. Our experience of using the Ilizarov fixation frame for achieving joint fusion is very rewarding. The results reported hereby justify the further use of this hybrid frame as an effective mechanical method to achieve bony joint fusion without bone grafts, and to ensure a low failure rate.