Ankle Fusion Using Retrograde Intramedullary Nail versus Ilizarov External Fixator in Charcot Neuroarthropathy

Abstract

Abstract Background Charcot neuroarthropathy is a destructive, non-infective process affecting bones and joints that occurs in association with a peripheral neuropathy and it has many etiologies but diabetes is the first cause of charcot neuroarthropathy. Aim of the Work to compare between retrograde intramedullary nail and ilizarov external fixator in ankle fusion in charcot neuroarthropathy regarding union rate, amputation, hardware complications, infection, need for reoperation. Materials and Methods This is systematic review done in Ain Shams University in December 2022 and Criteria for considering studies for this review: Results Retrograde intramedullary nail and ilizarov external fixator both are effective methods for ankle fusion in charcot neuroarthopathy. According to this review the union rate, amputation, hardware complications did not differ significantly between retrograde intramedullary nail and ilizarov in ankle fusion in charcot neuroarthropathy but the reoperation rate is higher with retrograde intramedullary nail. Regarding the infection rate there is no significant difference between the ilizarov and intramedullary nail but when considering the pin tract infection in ilizarov, the infection rate will become higher in ilizarov compared to the retrograde intramedullary nail. Conclusion this review provides evidence that both retrograde intramedullary nail and ilizarov external fixator are safe, effective and has comparable efficacy in limb salvage when used in ankle reconstruction in patients with charcot neurparthropathy, under the conditions that the surgical techniques required have been mastered and the indications for surgery are observed.