Surgical Technique: Achieving Anatomic Alignment With Temporizing, Ankle-Spanning External Fixation.

Abstract

Severe injuries to the ankle frequently result in soft tissue trauma too severe to proceed with immediate definitive fixation. Additionally, patients with multiple or vascular injuries may need a temporizing measure before undergoing definitive treatment. Temporizing, ankle-spanning external fixation offers a management strategy that allows for soft tissue rest and prioritized treatment of patients with polytrauma. The video demonstrates 2 clinical cases managed with temporizing, ankle-spanning external fixation: a pilon fracture and a bimalleolar ankle fracture-dislocation. The indications, advantages, and a systematic operative approach to applying ankle-spanning external fixation are presented. Specific attention is paid to restoring an anatomic alignment of the ankle. Temporizing, ankle-spanning external fixation is an important modality in the management of fractures about the ankle, especially in patients with dislocation and/or severe soft tissue injury. A systematic approach that initially addresses length, followed by sagittal and coronal plane correction, can be used to restore anatomic alignment of the ankle.