Ankle arthrodesis: combined internal-external fixation

This report documents the experience of using combined internal and external fixation in ankle arthrodesis. During the period from 1992 to 2000 a single surgeon used this method of fixation on 26 ankle fusions in 26 consecutive patients without exclusions. There were no nonunions and no delayed unions. The median time to union was 10.3 weeks and the mean time was 11.3 weeks (range, 7.4 to 23.2 weeks). Complications specific to this procedure included 3 (12%) minor pin tract infections which cleared with oral, out-patient antibiotics, 4 (15%) skin irritations from internal fixation pins sufficiently bothersome to require pin removal after union was obtained, and 1 (4%) painful pin tract which cleared spontaneously. Most of these complications occurred early in the series and subsequent changes in technique considerably decreased their incidence. This fixation technique produced excellent results. Combined internal and external fixation is recommended as a useful option in arthrodesis of the ankle.