Treatment of calcaneal osteomyelitis and defect deformity with bone transfer by Ilizarov technique

Abstract

To investigate the effectiveness of treatment of calcaneal osteomyelitis with bone transport by Ilizarov technique. Between January 2020 to August 2022, bone transfer using the Ilizarov technique was performed in 6 patients with calcaneal osteomyelitis. The patients were 4 males and 2 females; aged from 9 to 35 years (mean,21.2 ± 10.1 years). Cause of injury included 2 cases of high-fall injury, 2 cases of traffic accident, 1 case of crushing, and 1 case of other injuries. During the operation, we chose residual calcaneus or talus for bone transfer based on different conditions of the patient's illness. After removing the external fixator, several scoring systems were used to evaluate the recovery of the affected foot function. 6 patients were followed up 12–18 months (mean, 14.0 ± 2.3 months). Four cases of calcaneal osteomyelitis were decided to apply residual calcaneus for bone transfer, and the rest of them applied talus. The bone sliding time was 33–64 days (mean, 43.2 ± 11.8 days); the sliding distance was 3.2–5.0 cm (mean, 43.2 ± 11.8 cm). The time with external fixator was 6–8 months (mean, 6.5 ± 0.8 months). The Maryland score and the AOFAS ankle hindfoot score were all significantly higher than that before the operation (86.3 ± 7.2 VS 26.5 ± 5.5, 84.2 ± 5.8 VS 25.8 ± 6.6). Furthermore, the scores tested with the Visual Analogue Scale and Activity of daily living scale were significantly improved. Treatment of calcaneal osteomyelitis with bone transport by the Ilizarov technique can optimize the operation method, reduce the number of operations, and try to simulate the original shape of the calcaneus.