Foot drop after tibial lengthening osteotomy using Ilizarov and Orthofix external fixators

Yilihamujiang?Wusiman; Maimaitiming?Saiyiti; Abuduhaibier?Abula; Aihemaitijiang?Yusufu

doi:10.3969/j.issn.2095-4344.2016.22.012

Abstract：BACKGROUND:Tibial lengthening osteotomy has the advantages oflight trauma, less pain, fasthealing of bone that extended, and large amplitude of extension. However, it is often accompanied by a number of postoperative complications, among which postoperative foot drop is more common. It is one of the complicationsthat is more difficult to deal with clinicaly. <br> OBJECTIVE:To compare the incidence of foot drop after tibial lengthening osteotomy using Ilizarov external fixator and Orthofix external fixator. <br> METHODS:Clinical data of 148 patients with tibial defectstreated by tibial lengthening osteotomy in the Department of Micro-Reconstructive Surgery, First Affiliated Hospital of Xinjiang Medical University from July 2012 to May 2014 were retrospectively analyzed. Al patients were divided into two groups according to the type of fixators: Ilizarov external fixator group (n=72) and Orthofix external fixator group (n=76). The incidence of foot drop after tibial lengthening osteotomy was compared between the two groups. <br> RESULTS AND CONCLUSION:(1) Folow-up time was1-1.3 years. Tibial defects of al patients were repaired. (2) There were 37 patients with foot drop, including 26 cases in the Ilizarov external fixation group and 11 cases in the Orthofix external fixation group. The incidence of foot drop was significantly higher in the Ilizarov external fixator group than in the Orthofix external fixator group (36%, 15%;P< 0.05). (3) The foot drop was improved in 28 cases among the 37 patients. The remaining nine patients were lost to folow-up, so they affected severe foot drop. Self functional exercise and ankle joint mobilization could not correct the foot drop. Achiles tendon lengthening improved the foot drop. (4) These findings verify that the incidence of Ilizarov external fixator on tibial proximal osteotomyin patients with foot drop was significantly higher than that of the Orthofix External fixator. The authors believe that the occurrence of foot drop after tibial osteotomy is associated with the patient’s own and external fixation. Therefore, strictly surgical skils, preoperative careful design, intraoperative fine operation, postoperative folow-up and timely treatment are the keys to reduce foot drop after tibial lengthening osteotomy.