Tibial lengthening with ankle arthrodesis in poliomyelitic patients with unilateral dysfunction of both knee extension and ankle dorsiflexion

Abstract

Objective: The aim of this study was to assess the results of tibial lengthening with ankle arthrodesis in poliomyelitic patients with unilateral dysfunction of both knee extension and ankle dorsiflexion. Methods: Twenty-five consecutive adult patients with poliomyelitic sequelae of unilateral dysfunction of both knee extension and ankle dorsiflexion were treated. Patients had an average shorthening of 5.4 cm (range: 4.5–6.5 cm) on the affected side. The tibia was osteotomized and lengthened with external fixators, which were then replaced with plates supplemented with bone grafting. Ankle arthrodesis was performed concomitantly. Protected weight bearing was advised until bony union was achieved. Gait function was evaluated with Functional Mobility Scale and modified Mazur Scoring System. Results: Twenty-one patients were followed up for an average of 4.3 years (range: 2.0–8.2 years). External fixation was applied for an average of 6.2 weeks (range: 5–8 weeks). Complete bone healing was achieved in all patients and the average union time was 4 months (range: 3.5-4.5 months) after plating. At final follow-up, gait function significantly improved according to Functional Mobility Scale and modified Mazur Scoring System scores (p< 0.001 for both). Conclusion: The tibial lengthening with ankle arthrodesis appears to be an efficient alternative for treating poliomyelitic patients with unilateral dysfunction of both knee extension and ankle dorsiflexion.