Acta Scientific Orthopaedics (ISSN: 2581-8635)

Research Article Volume 6 Issue 3

The Outcome of Ankle Joint Fusion with Ring External Fixator in Patients with Charcot Arthropathy

Sami Nogdallah1, Insherah Dafalla Babiker Ali2, ALaa Mohamed Mohamed Khairy3, M Elghazali Abuelgassim E Mustafa4, Hozifa Mohammed Ali Abd-Elmaged5* and Montaser Fatooh6

1Orthopedic surgeon, Assistant Professor, Alneelain University, Khartoum, Sudan
2Orthopedics and Traumatology, Ibrahim Malik Teaching hospital, Khartoum, Sudan
3Orthopedic Resident, Sudan Medical Specialization Board, Sudan
4Orthopedic Registrar, Teaching assistant, Al-Zaiem Al-Azhari University AAU, Khartoum, Sudan
5Assistant Professor, Faculty of Medicine- Al-Zaiem Al-Azhari University, Khartoum, Sudan
6Assistant professor, Alneelain University, Khartoum-Sudan

*Corresponding Author: Hozifa Mohammed Ali Abd-Elmaged, Assistant Professor, Faculty of Medicine- Al-Zaiem Al-Azhari University, Khartoum, Sudan

Received: January 23, 2023; Published: February 13, 2023

Abstract

Background: Charcot neuroarthropathy is a severe disease involving several joints but most commonly affecting the foot and ankle. Charcot arthropathy is a serious late complication of many pathologies like diabetes mellitus, syphilis, and meningiomyelocele. It may result in fractures, permanent deformity, and even limb loss. Ankle fusion with internal fixation has high morbidity and complications. External fixation can provide stability to the joint and correction of the deformity with less risk for surgical complications.

Objectives: To assess the clinical and functional outcomes of ankle joint arthrodesis using external fixator in patients with severe Charcot ankle arthropathy.

Materials and Method: This study is descriptive cross-sectional hospital-based study that involved an 18 patients with advanced Charcot arthropathy of the ankle joint. Ankle fusion with Ilizarov external fixation was done for all patients. The patients were followed, and the frame was removed after clinical and radiological evidence of union were obtained. The American Orthopedic Foot and ankle Society scale (AOFAS) was assessed before surgery and one year after surgery. The post-operative complications and patient satisfaction also evaluated. The Data was analyzed using IMP SPSS version26.

Results: Number of patients was 18, 14 males and 4 females. The most frequent age group was more than 50 years (11 patients, 61.1%). Preoperative AOFAS score was poor for all of the patient (100%). The postoperative AOFAS score was improved, 6 patients (33.3%) obtained excellent result, 5 patients (27.8) good, 4 patients (22.2) fair, while 3 patients (16.7) remained poor. 13 patients (72.2%) were satisfied with the outcome while 5 of them (27.8%) were unsatisfied. The most frequent complication rate was for pin track infection which occurred in 6 patients (33.3%).

Conclusion: Fusion of the ankle joint with ring external fixator is useful treatment option for Charcot-arthropathy instability and deformity, particularly in cases where internal fixation methods are ineffective. With an acceptable rate of complications, it can lead to a satisfactory outcome and an improved functional score.

Keywords: Ankle Joint Arthrodesis; Charcot Arthropathy; Ring External Fixator

References

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  2. Armstrong DG and Peters EJ. “Charcot’s arthropathy of the foot”. Journal of the American Podiatric Medical Association7 (2002): 390-394.
  3. Richman J., et al. “Intramedullary nailing and external ring fixation for tibiotalocalcaneal arthrodesis in Charcot Arthropathy”. Foot and Ankle International2 (2016): 149-152.
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  7. Ismavel R., et al. “Tibiocalcaneal arthrodesis using a simple external fixator”. The Journal of Foot and Ankle Surgery4 (2014): 511-514.
  8. Karapinar H., et al. “Arthrodesis of neuropathic ankle joint by Ilizarov fixator in diabetic patients”. Journal of the American Podiatric Medical Association1 (2009): 42-48.
  9. Sheikh F., et al. “Charcots Arthropathy in Diabetics: An Experience in Treatment with Ilizarov External Fixator Technique”. Jornal Medical Thesis2 (2014): 12-17.
  10. El-Gafary KA., et al. “The management of Charcot joint disease affecting the ankle and foot by Arthrodesis controlled by an Ilizarov frame”. The Journal of Bone and Joint Surgery. British 91-B.10 (2009): 1322-1325.
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  12. et al. “In: StatPearls. Treasure Island (FL): StatPearls Publishing (2022).

Citation

Citation: Hozifa Mohammed Ali Abd-Elmaged., et al. “The Outcome of Ankle Joint Fusion with Ring External Fixator in Patients with Charcot Arthropathy”. Acta Scientific Orthopaedics 6.3 (2023): 114-119.

Copyright

Copyright: © 2023 Alaa Mohamed Mohamed Khairy., et al This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.




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