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The results of 8 patients who underwent triple arthrodesis with a rail external fixator were reviewed retrospectively. The frame construct allowed immediate axial loading and unrestricted ankle joint mobilization. Assistive ambulatory equipment was not required postoperatively. Periodic adjustment to compression was performed weekly until evidence of radiographic consolidation. The mean duration of frame application was 11.5 weeks. Follow-up averaged 15.9 months. Fusion occurred in all joints. One superficial pin-tract infection developed that resolved with oral antibiotics. The results of this study indicate that the rail frame system provides a viable fixation alternative for triple arthrodesis and warrants further investigation.