Ankle Arthrodesis After Joint Destruction from Septic Arthritis in a High-Risk Patient Using a Novel Intra-Articular Pinning Technique

CASE: A 75-year-old man presented with left ankle septic arthritis on a background of multiple surgeries for bilateral lower limb necrotizing fasciitis involving free flap and skin grafting. We employed a unique technique of ankle arthrodesis using intra-articular pinning with a combination of Schanz pins and Kirschner wires for ankle arthrodesis after joint destruction from septic arthritis following adequate debridement and curettage achieving partial union at 3 months and complete union by 6 months, with the patient returning to full activities of daily living at 1 year. CONCLUSION: This case demonstrates an effective and viable alternative strategy for ankle arthrodesis using a unique intra-articular pinning construct which functioned as a removable internal fixation construct in a patient with complex soft-tissue envelope.