Use of ring fixator in staged primary total ankle arthroplasty

Abstract

Post-traumatic osteoarthritis of the ankle is the main cause of degenerative joint disease of the ankle. The use of ring fixator has been historically used with the purpose to treat ankle arthritis as definitive treatment to avoid or delay arthrodesis or arthroplasty. To our knowledge, there are no reports in the literature describing the use of a ring fixator as a means of distracting the joint space to correct the shortening of the tibia. We present a case report of 57 year old woman with a tibial plafond fracture who underwent ORIF of both tibia and fibula with complications of pain and stiffness that were alleviated by hardware removal in conjunction with external fixation with the definitive treatment of total ankle arthroplasty. Postoperatively she had a routine course with uneventful wound healing and progression to full weightbearing at eight weeks. This case report demonstrates that the use of a circular external fixator to correct ankle alignment, restore the tibiotalar joint space and stretch the soft tissues prior to TAR is a viable treatment option in patients.