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Objective To explore the outcomes of circular external fixator in ankle tuberculosis. Methods A retrospective analysis of 14 (8 males, 6 females) consecutive patients with ankle tuberculosis (5 cases left sided and 9 cases right sided) treated with joint fusion surgery using circular external fixator at Wuhan Puai Hospital during the period of June 2005 to June 2011 were reviewed. The mean age at surgery was 46.2 (range 30 to 63) years. All the patients were treated with isoniazid, rifampicin, pyrazinamide and ethambutol for 3 to 6 months, then, after the osteotomy, debride- ment and joint fusion with circular external fixator-assisted were fixed. Some reasonable adjustments were done to promote joint fusion. Results The patients were followed up for 2 to 69 months (mean 23.7 months). No recurrence, 12 out of 14 patients with ankle digital convergence and stability, two with short-term follow-up of patients with stable external fixation and the X-ray shown ankle fixed in good position. Conclusion Circular external fixator-assisted arthrodesis found to be an effective method for the treatment of total ankle tuberculosis to fix the ankle in better position and achieve good clinical results.