Complex Tibiocalcaneal Arthrodesis and Staged Lengthening with Internal Lengthening Nail

Circular external fixators are a versatile and powerful tool to achieve a complex ankle fusion. Deep surgical site infection and need for gradual deformity correction, due to neurovascular and soft tissue considerations, are two situations when a frame is particularly useful. We discuss a case of revision complex tibiotalarcalcaneal (TTC) fusion and leg length equalization in the context of bone stock loss and deep surgical site infection. The case will illustrate how a circular external fixator can be used simultaneously with an motorized internal lengthening nail.