Abstract
Joint-spanning external fixation in acute ankle trauma is a means to provide temporary stability and restoration of length, alignment, and articular congruency. This allows for soft-tissue consolidation before definitive fixation to decrease the risk of wound complications. Traction is commonly used during definitive fixation to aid in fracture reduction and to maintain reduction during placement of internal hardware. Ankle arthroscopy for ankle fractures is also becoming increasingly popular to identify and treat intra-articular injury and uses traction for visual assistance and increased working space for instruments. We present a technique that uses a previously placed calcaneus external fixation pin and the TRIMANO (Arthrex, Naples, FL) external positioning arm to apply skeletal traction during arthroscopic and open definitive fixation procedures. This technique is extremely simple, can be used in both the supine and prone positions, and can be used during arthroscopic and open procedures.