TARSOCRURAL ARTHRODESIS - A CLINICAL REPORT USING A CIRCULAR EXTERNALFIXATOR

Arthrodesis is a well documented treatment option for comminuted intra articular fractures, irreparable collateral ligament injuries, limb sa lvage for ischiatic nerve injury, and severe degenerative joint diseas e of the tarsocrural joint (1-6). Conservative splint or bandage appli cation often results in a less than favorable outcome in the managemen t of these types of injuries. Common techniques to achieve tarsocrural arthrodesis include divergent Steinmann pin placement, lag screw or c ompression plating and external skeletal fixation (1-5). This report d escribes a tarsocrural arthrodesis using a circular external fixation system to manage an open, severely contaminated, comminuted intra-arti cular fracture of the talus and calcaneous, with extensive soft tissue degloving injuries. The decision to use a circular external fixation system was based on its ability to (1) adequately stabilize the tibial -tarsal region, (2) be applied with minimal soft tissue and vascular d isruption, (3) allow adequate post-operative soft tissue wound managem ent, and (4) be tolerated well by the patient allowing early weight be aring of the limb.