Ilizarov external fixator in foot and ankle reconstruction

Purpose of review: The Ilizarov external fixator and method were developed in the 1950s , but they continue to remain a point of interest owing to encouraging clinical outcomes. This review discusses recent advances in foot and ankle reconstructive surgery utilizing the Ilizarov methods for ankle fusions, calcaneal fractures, and osteoarthritis. Recent findings: Ankle arthrodesis utilizing an Ilizarov frame has been reported as a mainstay of surgical treatment for failed ankle fusions as well as in primary ankle arthrodesis. The advantages of external fixation include substantial interfragmentary compression combined with additional stability in cases with poor bone quality and questionable screw purchase. Another promising area is using the Ilizarov frame for the minimally invasive treatment of calcaneus fractures. The advantage of the Ilizarov frame over open reduction internal fixation techniques is the inability to restore bony anatomy in the presence of compromised soft tissues. In 2005, a study with a 7-year follow-up was published on the result of ankle joint distraction for osteoarthritis treatment. Although 27% of cases were failures and arthrodesis had to be performed, 73% of patients showed significant improvement in all parameters. The underlying mechanism of the clinical benefit obtained remains unclear. Summary: The treatment of foot and ankle disorders with the Ilizarov method continues to evolve, with further advancements in frames and techniques reported in the growing body of published literature.