Ilizarov ring fixator for ankle fusion: a gold standard in managing complex ankle pathologies

Introduction Ankle arthrodesis is a surgical procedure for end-stage arthritis and complex ankle pathologies, offering a limb-salvaging alternative to amputation. This study aims to present clinical experience with the Ilizarov apparatus in achieving stable, painless ankle fusion in patients with varied complex ankle pathologies. Materials and Methods A retrospective study was conducted involving 27 patients who underwent ankle arthrodesis using the Ilizarov fixator between 2014 and 2024. Clinical and radiological evaluations were performed using the ASAMI scoring system. Surgical techniques, patient demographics, and outcomes were analyzed. Results All 27 patients achieved successful bone union. ASAMI Bone results were rated excellent in 23 and good in 4. Functional outcomes were rated as good in 22 patients and fair in 5. Pin tract infections were effectively managed with antibiotics. The Ilizarov technique demonstrated superior results in achieving stable, pain-free ankles, even in cases with severe osteomyelitis and destroyed ankles with deformities. Discussion The Ilizarov apparatus provides a minimally invasive, versatile approach for complex ankle pathologies, enabling dynamic axial compression, early weight-bearing, and deformity correction. Despite limitations such as high costs and skill requirements, its success rate surpasses that of internal fixation techniques. Conclusion The Ilizarov apparatus is the gold standard for ankle arthrodesis, offering stable fusion and addressing comorbidities such as osteomyelitis and limb length discrepancy, with high patient satisfaction and functional recovery.