CME OnDemand: 2022 AOFAS Annual Meeting-Arthroscopic Ankle Arthrodesis with Circular External Fixator: Case Report

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This case report discusses the use of arthroscopic ankle arthrodesis with a circular external fixator in the treatment of a tibial pilon fracture. Pilon fractures are rare and can result in severe complications such as soft tissue infection, osteomyelitis, and post-traumatic arthrosis. The circular external fixator is a surgical option that has shown good outcomes with a low incidence of complications compared to open reduction and internal fixation.<br /><br />The patient in this case was a 56-year-old male who had a tibial pilon fracture due to a motorcycle accident. Initially, uniplanar external fixation was performed for alignment and soft tissue care. Subsequently, transarticular circular external fixation was used, and regular follow-up was initiated. However, the patient experienced pain and radiographic evidence of tibiotarsal arthrosis, leading to the decision to perform arthroscopic arthrodesis.<br /><br />The arthroscopic procedure was performed with two experienced foot and ankle surgeons. After accessing the joint through portals, joint debridement and preparation were performed using a shaver blade. Joint compression was then achieved using the already installed external fixator. The patient demonstrated complete consolidation of the tibio-tarsal arthrodesis and had good functional outcomes.<br /><br />The use of the circular external fixator in ankle arthrodesis was first proposed in 1976 and has since shown positive results, particularly in complex fractures or infections. However, there is limited literature on the combination of arthroscopic joint preparation with circular external fixation. This case report highlights the technique's success and calls for further research and discussion on arthroscopic ankle arthrodesis using the Ilizarov method.

Asset Subtitle

Caio A. Araujo, Vinícius F. Pereira, Nacime SB Mansur, MD

Keywords

arthroscopic ankle arthrodesis

circular external fixator

tibial pilon fracture

soft tissue infection

osteomyelitis

post-traumatic arthrosis

uniplanar external fixation

transarticular circular external fixation

arthroscopic arthrodesis

tibio-tarsal arthrodesis