Ankle spanning external fixators are indicated for higher energy injuries where there is a need to "span, scan and plan" i.e. a pilon fracture; an open ankle fracture; a talar body dislocation, or those where there are significantly traumatised soft tissues. Having said that, the first step in your treatment algorithm should be immediate.. External fixation allows up to three planes of stability, which provides mobilization and weightbearing of unaffected joints such as the metatarsal phalangeal and the ankle joint. Better soft tissue and wound care are also afforded. A good knowledge of foot anatomy is necessary for neurovascular safety.
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Preparation. commonly used for acute management of pilon and unstable ankle fractures or in presence of compromised soft tissues. CT performed after fixator to better delineate fracture pattern. setup OR with radiolucent table and C-arm perpendicular from contralateral side. Positioning.. Joint-spanning external fixation in acute ankle trauma is a means to provide temporary stability and restoration of length, alignment, and articular congruency. This allows for soft-tissue consolidation before definitive fixation to decrease the risk of wound complications. Traction is commonly used during definitive fixation to aid in fracture reduction and to maintain reduction during.
