Applications of ring fixators in complex foot and ankle trauma.

There is a growing base of literature that supports the use of external ring fixators in the treatment of complex foot and ankle fractures. Clinical studies that determine definitively the optimal treatment for particular injuries are absent. Small wire ring fixators have a growing role in allowing the stabilization of complex skeletal injuries with a minimum of iatrogenic soft tissue injury. Ring fixators should be considered in the algorithm of treatment of complex lower extremity fractures with associated significant soft tissue injury. One of the cornerstones of trauma management is the preservation of reconstructive options after injury. As interest in ankle arthroplasty increases and experience broadens, such options may be available to patients who sustain severe tibial plafond or talus fractures. It is imperative that hindfoot alignment and height be maintained and infection avoided so that reconstructive osteotomy, arthrodesis, and arthroplasty remain as options for patients who sustain severe trauma.