Use of Ring External Fixator in a Case of Open Lisfranc Injury

Ring external fixators have been used primarily in open or comminuted fractures of long bones. Managing complex trauma, especially that of the foot, always requires an element of innovation using the existing techniques of fixation. A 21-year-old male presented with a crush injury of the right foot with a laceration over the medial plantar aspect of the foot resulting in a Lisfranc’s injury with disruption of the midfoot and fracture of the right tibia and fibula. The patient was managed with an Ilizarov ring external fixator spanning the midfoot, which would undergo distraction. The tibia fracture was managed by closed reduction and intramedullary nailing. After 3 months, the skin condition improved, and the fracture united. The length of the foot was restored as well, with a better alignment. The Ilizarov external fixator provided adequate stability and helped the soft-tissue heal despite initially developing blebs and skin necrosis.