Ilizarov-Assisted Ankle Arthrodesis for Advanced Post-Traumatic Ankle Osteoarthritis: Clinical and Functional Outcomes

Open Access

Abstract

Background: Ilizarov external fixation enables gradual correction and arthrodesis in severe ankle arthritis with bone loss or deformity. However, outcome data from resource-limited settings remain limited, particularly regarding union rates and functional recovery in Bangladesh. This study addresses this gap. Objective: To evaluate clinical and functional outcomes of Ilizarov-assisted ankle arthrodesis in advanced post-traumatic ankle osteoarthritis. Methods & Materials: This prospective observational study was conducted at NITOR, Dhaka, from January 2021 to December 2025. A total of 30 patients with advanced post-traumatic ankle osteoarthritis underwent Ilizarov-assisted ankle arthrodesis. Union rate, time to union, functional scores, and complications were recorded. Clinical and functional outcomes were assessed using standardized criteria. Data were analyzed using SPSS version 23.0. Results: Bony union was achieved in 28 patients (93.3%), with a mean time to union of 16.8 ± 3.4 weeks. The mean AOFAS score improved from 42.6 ± 10.8 preoperatively to 78.4 ± 8.6 postoperatively (p<0.001). Pin site infection occurred in 23.3%, nonunion in 6.7%, and malunion in 3.3%. No cases of neurovascular injury or amputation were observed. Conclusion: Ilizarov-assisted ankle arthrodesis achieves high union rates and significant functional improvement in advanced post-traumatic ankle osteoarthritis, with acceptable complication rates. This technique offers a reliable limb salvage option in resource-limited settings where alternative reconstructive procedures may be unavailable.