{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,2]],"date-time":"2026-07-02T10:53:20Z","timestamp":1782989600997,"version":"3.54.5"},"reference-count":29,"publisher":"British Editorial Society of Bone & Joint Surgery","issue":"3","license":[{"start":{"date-parts":[[2009,3,1]],"date-time":"2009-03-01T00:00:00Z","timestamp":1235865600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/online.boneandjoint.org.uk\/TDM"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["The Journal of Bone and Joint Surgery. British volume"],"published-print":{"date-parts":[[2009,3]]},"abstract":"<jats:p> We present the results of ankle fusion using the Ilizarov technique for bone loss around the ankle in 20 patients. All except one had sustained post-traumatic bone loss. Infection was present in 17. The mean age was 33.1 years (7 to 71). The mean size of the defect was 3.98 cm (1.5 to 12) and associated limb shortening before the index procedure varied from 1 cm to 5 cm. The mean time in the external fixator was 335 days (42 to 870). Tibiotalar fusion was performed in 19 patients and tibiocalcaneal fusion in one. Associated problems included diabetes in one patient, pelvic and urethral injury in one, visual injury in one patient and ipsilateral tibial fracture in five. At the final mean follow-up of 51.55 months (24 to 121) fusion had been achieved in 19 of 20 patients. A total of 16 patients were able to return to work. The results were graded as good in 11 patients, fair in six and poor in three. The mean external fixation index was 8.8 days\/mm (0 to 30). One patient with diabetes developed severe infection which required early removal of the fixator. Refractures occurred in three patients, two of which were at the site of fusion and one at a previous tibial shaft fracture site. Equinus deformity of the ankle fusion occurred after a further fracture in one patient. There were two patients with residual forefoot equinus, and one developed late valgus at the fusion site. <\/jats:p><jats:p> Poor consolidation of the regenerated bone in two patients was treated by bone grafting in one and by bone and fibular strut grafting in the other. Residual soft-tissue infection was still present in two patients. <\/jats:p>","DOI":"10.1302\/0301-620x.91b3.20935","type":"journal-article","created":{"date-parts":[[2009,3,3]],"date-time":"2009-03-03T22:48:56Z","timestamp":1236120536000},"page":"361-366","source":"Crossref","is-referenced-by-count":20,"title":["Ankle fusion for bone loss around the ankle joint using the Ilizarov technique"],"prefix":"10.1302","volume":"91-B","author":[{"given":"C. C.","family":"Kovoor","sequence":"first","affiliation":[{"name":"Specialist Hospital, Eranakulam Kochi, Kerala, India 682018."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"V.","family":"Padmanabhan","sequence":"additional","affiliation":[{"name":"Specialist Hospital, Eranakulam Kochi, Kerala, India 682018."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D.","family":"Bhaskar","sequence":"additional","affiliation":[{"name":"Department of Trauma and Orthopaedics Dewsbury and District Hospital, 107 Broomer Street, Ravensthorpe, Dewsbury, West Yorkshire WF13 3DF, UK."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"V. V.","family":"George","sequence":"additional","affiliation":[{"name":"Eranakulam Medical Centre, By-Pass, Palarivattom, Kochi-682028, India."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S.","family":"Viswanath","sequence":"additional","affiliation":[{"name":"Specialist Hospital, Eranakulam Kochi, Kerala, India 682018."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"42","reference":[{"key":"R1","doi-asserted-by":"crossref","unstructured":"Sakurakichi K, Tsuchiya H, Uehara K, et al. Ankle arthrodesis combined with tibial lengthening using the Ilizarov apparatus. J Orthop Sci 2002;8:20\u20135.","DOI":"10.1007\/s007760300003"},{"key":"R2","doi-asserted-by":"publisher","DOI":"10.1097\/00003086-200110000-00006"},{"key":"R3","doi-asserted-by":"crossref","unstructured":"Kitaoka HB, Anderson PJ, Morrey BF. Revision of ankle arthrodesis with external fixation for non-union. J Bone Joint Surg [Am] 1992;74-A:1191\u2013200.","DOI":"10.2106\/00004623-199274080-00009"},{"key":"R4","doi-asserted-by":"publisher","DOI":"10.1302\/0301-620X.70B1.3339041"},{"key":"R5","doi-asserted-by":"crossref","unstructured":"Johnson EE, Weltmer J, Lian GJ, Cracchiolo A 3rd. Ilizarov ankle arthrodesis. Clin Orthop 1992;280:160\u20139.","DOI":"10.1097\/00003086-199207000-00019"},{"key":"R6","doi-asserted-by":"publisher","DOI":"10.1302\/0301-620X.87B2.15874"},{"key":"R7","unstructured":"Paley D. Biomechanics of the Ilizarov external fixator: In: Bianchi Maiocchi A, Aronson J, eds. Operative principles of Ilizarov fracture treatment, nonunion, osteomyelitis, lengthening, deformity correction. Baltimore: Williams and Wilkins, 1991:34."},{"key":"R8","unstructured":"Bianchi-Maiocchi A. Advances in Ilizarov apparatus assembly: fracture treatment, pseudarthroses, lengthening, deformity correction. Medicalplastic srl, 1994; Section I:3."},{"key":"R9","doi-asserted-by":"crossref","unstructured":"Hawkins BJ, Langerman DO, Anger DM, Calhoun JH. The Ilizarov technique in ankle fusion. Clin Orthop 1994;303:217\u201325.","DOI":"10.1097\/00003086-199406000-00029"},{"key":"R10","unstructured":"Ilizarov S, Rozbruch SR, Blyakhert A. Ankle fusion with simultaneous lengthening by using the Ilizarov method. Scientific poster #86 reconstruction. OTA 2003; Posters-http:\/\/www.hwbf.org\/ota\/am\/ota03\/otapo\/OTP03086.htm (date last accessed 15 April 2008)."},{"key":"R11","doi-asserted-by":"publisher","DOI":"10.1302\/0301-620X.88B8.16768"},{"key":"R12","doi-asserted-by":"crossref","unstructured":"Katsenis D, Bhave A, Paley D, Herzenberg JE. Treatment of malunion and non-union at the site of an ankle fusion with the ilizarov apparatus. J Bone Joint Surg [Am] 2005;87-A:302\u20139.","DOI":"10.2106\/JBJS.C.01421"},{"key":"R13","doi-asserted-by":"crossref","unstructured":"Bishop AT, Wood MB, Sheetz KK. Arthrodesis of the ankle with a free vascularized autogenous bone graft: reconstruction of segmental loss of bone secondary to osteomyelitis, tumor, or trauma. J Bone Joint Surg [Am] 1995;77-A:1867\u201375.","DOI":"10.2106\/00004623-199512000-00011"},{"key":"R14","doi-asserted-by":"publisher","DOI":"10.1097\/00006534-199908000-00016"},{"key":"R15","doi-asserted-by":"publisher","DOI":"10.1111\/j.1432-2277.1995.tb01548.x"},{"key":"R16","doi-asserted-by":"publisher","DOI":"10.1302\/0301-620X.88B12.17879"},{"key":"R17","unstructured":"Cierny G 3rd, Cook WG, Mader JT. Ankle arthrodesis in the presence of ongoing sepsis: indications, methods, and results. Orthop Clin North Am 1989;20:709\u201321."},{"key":"R18","unstructured":"Villa A. Principles of treatment. In: Bianchi-Maiocchi, Aronson J, eds. Operative principles of Ilizarov: fracture treatment, nonunion, osteomyelitis, lengthening, deformity correction. Baltimore: Williams &\n Wilkins. 1991:196."},{"key":"R19","unstructured":"Saltzman CL. Salvage of diffuse ankle osteomyelitis by single stage resection and circumferential compression frame arthrodesis. Iowa Orthop 2005;25:47\u201352."},{"key":"R20","doi-asserted-by":"crossref","unstructured":"Kollig E, Esenwein S, Muhr G, Kutscha-Lissberg F. Fusion of the septic ankle: experience with 15 cases using hybrid external fixation. J Trauma 2002;55:685\u201391.","DOI":"10.1097\/01.TA.0000051933.83342.E4"},{"key":"R21","doi-asserted-by":"publisher","DOI":"10.1080\/000164700317411915"},{"key":"R22","doi-asserted-by":"publisher","DOI":"10.1053\/j.jfas.2004.11.004"},{"key":"R23","doi-asserted-by":"crossref","unstructured":"Milgram JW. Osteomyelitis in the foot and ankle associated with diabetes mellitus. Clin Orthop 1993;296:50\u20137.","DOI":"10.1097\/00003086-199311000-00010"},{"key":"R24","doi-asserted-by":"crossref","unstructured":"Calhoun JH, Li F, Ledbetter BR, Gill CA. Biomechanics of the Ilizarov fixator for fracture fixation. Clin Orthop 1992;280:15\u201322.","DOI":"10.1097\/00003086-199207000-00004"},{"key":"R25","doi-asserted-by":"crossref","unstructured":"Eralp L, Kocaoglu M, Yusof NM, Bulbul M. Distal tibial reconstruction with use of a circular external fixator and an intramedullary nail: the combined technique. J Bone Joint Surg [Am] 2007;89-A:2218\u201324.","DOI":"10.2106\/JBJS.F.01579"},{"key":"R26","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa012604"},{"key":"R27","doi-asserted-by":"crossref","unstructured":"MacKenzie EJ, Jones AS, Bosse MJ, et al. Health-care costs associated with amputation or reconstruction of a limb threatening injury. J Bone Joint Surg [Am] 2007;89-A:1685\u201392.","DOI":"10.2106\/JBJS.F.01350"},{"key":"R28","doi-asserted-by":"crossref","unstructured":"Swiontkowski MF, Bosse MJ, Kellam J, et al. Factors influencing the decision to amputate or reconstruct after high energy lower extremity trauma. J Trauma 2002;52:641\u20139.","DOI":"10.1097\/00005373-200204000-00005"},{"key":"R29","doi-asserted-by":"crossref","unstructured":"Dahl MT, Gulli B, Berg T. Complications of limb lengthening: a learning curve. Clin Orthop 1994;310:10\u201318.","DOI":"10.1097\/00003086-199404000-00003"}],"container-title":["The Journal of Bone and Joint Surgery. British volume"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/online.boneandjoint.org.uk\/doi\/pdf\/10.1302\/0301-620X.91B3.20935","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/online.boneandjoint.org.uk\/doi\/full-xml\/10.1302\/0301-620X.91B3.20935","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/online.boneandjoint.org.uk\/doi\/pdf\/10.1302\/0301-620X.91B3.20935","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,8,16]],"date-time":"2021-08-16T18:09:37Z","timestamp":1629137377000},"score":1,"resource":{"primary":{"URL":"https:\/\/online.boneandjoint.org.uk\/doi\/10.1302\/0301-620X.91B3.20935"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2009,3]]},"references-count":29,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2009,3]]}},"alternative-id":["10.1302\/0301-620X.91B3.20935"],"URL":"https:\/\/doi.org\/10.1302\/0301-620x.91b3.20935","relation":{},"ISSN":["0301-620X","2044-5377"],"issn-type":[{"value":"0301-620X","type":"print"},{"value":"2044-5377","type":"electronic"}],"subject":[],"published":{"date-parts":[[2009,3]]}}}