Recent innovations and future directions in external fixation of the foot and ankle.

Although the basic design of external fixators has changed little in the last 50 years, advances in pin engineering are decreasing rates of infection and loosening. Newer limb-specific frames are easier to apply to the ankle and novel designs in ring fixators are improving the field of deformity correction. Just as important as any technical improvement, though, is a more refined understanding of the merits and weaknesses of the technique. There are many applications in which external fixation is the best option and others in which it is the only surgical option. Because of this, external fixation will remain an essential tool for future orthopedic surgeons.