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Patients\u2019 age ranged from 26 to 62 (mean, 42\u2009\u00b1\u20099.5) years old. The types of fractures were distal tibia fracture (25 cases), distal tibia and fibula fracture (5 cases), and talus fracture (2 cases). All patients underwent treatment with unilateral external fixation combined with bone transport and tibio-talar fusion. 6 patients with severe infection received two-stage treatment involving focal debridement and external fixation, osteotomy, and bone transport. The remaining 26 patients underwent debridement, external fixation, and osteotomy simultaneously. The length of bone transport, total fixation time of the external fixator, and postoperative complications were recorded for all patients. The efficacy of the treatment was assessed using the American Association of Foot and Ankle Society (AOFAS) ankle\u2013hindfoot score.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Patients were followed up for 16\u201336\u00a0months, with an average follow-up time of 24\u00a0months. The length of tibia bone transport ranged from 5 to 15\u00a0cm, with a mean length of 8.5\u00a0cm. The external fixator was applied for 12\u201324\u00a0months, with an average duration of 16\u00a0months. One patient suffered from refracture at tibio-talar fusion site, and one patient had external fixation pin-tract infection. No complications, such as recurrent infections (especially the MRSA infection), poor mineralization, refracture, iatrogenic nerve damage or fusion failure, were found in the remaining patients. The preoperative AOFAS ankle\u2013hindfoot function score was 40.0\u2009\u00b1\u20093.8 (range, 30\u201352) points, and it increased to 75.0\u2009\u00b1\u20093.0 (range, 67\u201378) points at the last follow-up.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>A unilateral external fixator combined with bone transport and tibio-talar fusion is an effective method for treating severe postoperative infection of peri-ankle fractures. This approach is capable of reconstructing large bone defects that remain after clearing the infected lesion. Additionally, it provides stability to the ankle, enhances ankle\u2013hindfoot function, and improves the patient\u2019s quality of life.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s13018-024-04586-2","type":"journal-article","created":{"date-parts":[[2024,2,2]],"date-time":"2024-02-02T08:02:44Z","timestamp":1706860964000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["A unilateral external fixator combined with bone transport and tibio-talar fusion for the treatment of severe postoperative infection of peri-ankle fractures: retrospective analysis of 32 cases"],"prefix":"10.1186","volume":"19","author":[{"given":"Qinghu","family":"Li","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xin","family":"Wang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yonghui","family":"Wang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fanxiao","family":"Liu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Baisheng","family":"Fu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2024,2,2]]},"reference":[{"key":"4586_CR1","volume-title":"Rockwood and Green\u2019s fractures in adults","author":"CM Court-Brown","year":"2015","unstructured":"Court-Brown CM. 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