Utilization of Ilizarov circular fine wire frame adjacent to prior antegrade tibial nails for tibiotalar management: A novel technique

Abstract

Circular fine-wire external fixator frames, also known as Ilizarov frames, in lower extremity surgery have been well documented and established surgical treatment of various pathologies. Fine wire frames utilize a stable energy transferring construct for its various treatments. Adequate bicortical purchase of tibia bone is necessary for proper tensioning and avoiding iatrogenic fractures. When a patient has a prior antegrade tibial nail that has been orthopedically deemed non-removable without potential further harm to the patient, this leaves little working space for a circular finewire frame due to hindrance. This paper outlines our institution's novel technique in utilizing a circular fine-wire frame around tibial nails for the treatment of unique lower extremity pathologies utilizing the novel rule of orthogonal oblique margins of a nail. We discuss two cases with two separate etiologies who had a previous antegrade tibial nail and later was a candidate for a circular fine-wire frame for surgical treatment of their unique pathology.

Keywords

• VII
• Technique Guide