Purpose: The retrospective evaluation of the results of the application of the ring and hybrid systems of external fixation for the management of the high energy injuries of the talus.

Material and Methods: Between 1990–2001, seventeen patients with complex injuries of the talus were treated with the application of ring or hybrid fixators. Eleven patients were males and six females. Isolated fracture of the talus was recorded in five patients, fracture- dislocation in four and pantalar dislocation in eight. The injury was open in twelve patients. Six patients had multiple injuries. To classify the talar injury we used the systems of Hawkins and Marti/Weber. Tension wire fixation with the use of either Ilizarov or hybrid frames was applied in all fractures. Additional internal fixation was performed in eleven fractures. The fixation was extended at the forefoot in all fractures. Results were assessed using Kiel’s evaluation system.

Results: The mean follow up was 42 months (range, 25 to 96). We had no cases with deep infection, wound break down, osteomyelitis, or septic arthritis. We had five excellent, eight good, three fair and one poor result. The final radiographic appearance was not satisfactory in six fractures. Avascular necrosis of the talus was diagnosed in four fractures (23.5%).

Conclusions: Using the ring and hybrid external fixation systems a satisfactory reduction of the high energy fractures and dislocations of the talus with the maximum respect of the anatomical architecture of the adjacent tissues can be achieved. The method offers an excellent stability of the fracture, diminishes the rate of the postoperative infection, and reduces significantly the risk of talus avascular necrosis.