Chinese Journal of Tissue Engineering Research ›› 2016, Vol. 20 ›› Issue (22): 3279-3286.doi: 10.3969/j.issn.2095-4344.2016.22.012

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

Yilihamujiang•Wusiman, Maimaitiming•Saiyiti, Abuduhaibier•Abula, Aihemaitijiang•Yusufu   

  1. Department of Micro-Reconstructive Surgery, First Affiliated Hospital of Xinjiang Medical University, Urumqi 830054, Xinjiang Uygur Autonomous Region, China
  • Revised:2016-03-18 Online:2016-05-27 Published:2016-05-27
  • Contact: Aihemaitijiang?Yusufu, Chief physician, Professor, Department of Micro-Reconstructive Surgery, First Affiliated Hospital of Xinjiang Medical University, Urumqi 830054, Xinjiang Uygur Autonomous Region, China
  • About author:Yilihamujiang?Wusiman, Studying for master’s degree, Department of Micro-Reconstructive Surgery, First Affiliated Hospital of Xinjiang Medical University, Urumqi 830054, Xinjiang Uygur Autonomous Region, China

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Abstract:

BACKGROUND: Tibial lengthening osteotomy has the advantages of light trauma, less pain, fast healing 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 complications that is more difficult to deal with clinically.

OBJECTIVE: To compare the incidence of foot drop after tibial lengthening osteotomy using Ilizarov external fixator and Orthofix external fixator.
METHODS: Clinical data of 148 patients with tibial defects treated 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. All 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.
RESULTS AND CONCLUSION: (1) Follow-up time was 1-1.3 years. Tibial defects of all 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 follow-up, so they affected severe foot drop. Self functional exercise and ankle joint mobilization could not correct the foot drop. Achilles tendon lengthening improved the foot drop. (4) These findings verify that the incidence of Ilizarov external fixator on tibial proximal osteotomy in 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 skills, preoperative careful design, intraoperative fine operation, postoperative follow-up and timely treatment are the keys to reduce foot drop after tibial lengthening osteotomy. 
中国组织工程研究杂志出版内容重点：人工关节；骨植入物；脊柱；骨折；内固定；数字化骨科；组织工程

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