Temporary external fixation for the management of complex intra- and periarticular fractures of the lower extremity

Complex intra-articular and periarticular fractures of the lower extremity are challenging injuries to treat. Recently, the concept of utilizing a staged approach with temporary external fixation, a delay to allow soft-tissue healing followed by open reduction and internal fixation, has gained popularity. Historically high complication rates appear to be significantly improved with this strategy. Temporary external fixation is also useful in other settings, such as in the initial management of polytraumatized patients with multiple complex fractures, augmentation of internal fixation in osteoporotic bone, etc. This article reviews current indications, techniques, potential complications, and results of temporary external fixation for complex fractures of the lower extremity.