Summary
Arthrodesis is a well documented treatment option for comminuted intraarticular fractures,
irreparable collateral ligament injuries, limb salvage for ischiatic nerve injury,
and severe degenerative joint disease of the tarsocrural joint (1-6). Conservative
splint or bandage application often results in a less than favorable outcome in the
management of these types of injuries. Common techniques to achieve tarsocrural arthrodesis
include divergent Steinmann pin placement, lag screw or compression plating and external
skeletal fixation (1-5). This report describes a tarsocrural arthrodesis using a circular
external fixation system to manage an open, severely contaminated, comminuted intra-articular
fracture of the talus and calcaneous, with extensive soft tissue degloving injuries.
The decision to use a circular external fixation system was based on its ability to
(1) adequately stabilize the tibialtarsal region, (2) be applied with minimal soft
tissue and vascular disruption, (3) allow adequate post-operative soft tissue wound
management, and (4) be tolerated well by the patient allowing early weight bearing
of the limb.
Severe tarsocrural injuries were diagnosed on a four-year-old mixed breed dog including
articular fractures of the tubercalcaneous, talus, fibula, multiple tarsal bones and
the second metatarsal bone. A circular ring external fixator was used to arthrodese
the joint. Twelve weeks following surgery the limb was functional without any mechanical
gait alteration and with minimal to zero discomfort.
Keywords
Ilizarov’s ring fixator - circular fixator - tarsocrural arthrodesis
