Summary:Compression arthrodesis of the ankle has been shown to be successful utilizing either external or internal methods of fixation. Recent studies have supported a trend toward the use of internal fixation because it has a high incidence of successful ankle arthrodesis and a lower incidence of complications compared with prior methods of external fixation. Patients with a history of sepsis or severe soft tissue trauma and resultant scarring, or patients with large bony defects, may be poor candidates for internal fixation. Elderly or infirm patients may be unable to tolerate extended periods of being non-weight-bearing on the operative extremity as required by techniques of rigid internal fixation. Ten such patients underwent compression arthrodesis of the ankle utilizing a ring external fixation device. All 10 patients (100%) demonstrated solid bony fusion in appropriate positions. All patients were able to maintain their weight-bearing status during the application of the external fixation device. One patient demonstrated a superficial infection at a transfixion pin site, which resolved following a short course of oral antibiotic therapy. Patient compliance was good. This technique represents an alternative to internal fixation for reliable ankle arthrodesis