Spina bifida neuropathic foot osteomyelitis : results of using ilizarov technique in 46 cases

Abstract

Neuropathic foot osteomyelitis is a challenging condition for both surgeon and patient, we retro- spectively reviewed patients with spina bifida who had chronic foot osteomyelitis presented to our centre from 1995 to 2016. The study yielded 46 patients with chronically infected and deformed feet with a mean age of 31.26 years (range : 18-70 years ; SD : 9.61) and Mean follow-up of 5.76 years (range 1- 21years ; SD : 3.9). Our technique included a staged debridement IV chemotherapy and ilizarov fixation followed by arthrodesis in 44 cases and calcanisation in two cases. American Orthopedic Foot and Ankle Association (AOFAS) score was used to assess the results with a Pre-operative mean of (72.73 ± SD10.11) and a value of (82.32 ± SD 7.5) at final follow-up respectively, P-value was 0.29. Laboratory, x-ray, CT scans and foot prints were used to assess pre and postoperative results. Overall 76% had good outcome with a plantigrade stable united and infection free feet. Those with recurrences were treated with the same technique and achieved the final goal of treatment. Using ilizarov technique in the treatment of neuropathic spina bifida foot osteomyelitis presents a reliable and more suitable option for those patients with infected deformed and stiff feet.