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Ankle fusion with tibiotalocalcaneal retrograde nail for fragility ankle fractures: outcomes at a major trauma centre.

cam.issuedOnline2021-11-24
cam.orpheus.successTue Feb 01 19:02:18 GMT 2022 - Embargo updated*
dc.contributor.authorLu, Victor
dc.contributor.authorTennyson, Maria
dc.contributor.authorZhang, James
dc.contributor.authorThahir, Azeem
dc.contributor.authorZhou, Andrew
dc.contributor.authorKrkovic, Matija
dc.contributor.orcidLu, Victor [0000-0002-6818-1683]
dc.contributor.orcidZhang, James [0000-0002-2965-8709]
dc.contributor.orcidThahir, Azeem [0000-0003-3394-9418]
dc.contributor.orcidZhou, Andrew [0000-0001-6656-8123]
dc.contributor.orcidKrkovic, Matija [0000-0003-2172-2849]
dc.date.accessioned2021-11-24T00:30:16Z
dc.date.available2021-11-24T00:30:16Z
dc.date.issued2021-11-24
dc.description.abstractPURPOSE: Fragility ankles fractures in the geriatric population are challenging to manage, due to fracture instability, soft tissue compromise, and patient co-morbidities. Traditional management options include open reduction internal fixation, or conservative treatment, both of which are fraught with high complication rates. We aimed to present functional outcomes of elderly patients with fragility ankle fractures treated with retrograde ankle fusion nails. METHODS: A retrospective observational study was performed on patients who underwent intramedullary nailing with a tibiotalocalcaneal nail. Twenty patients met the inclusion criteria of being over sixty and having multiple co-morbidities. Patient demographics, AO/OTA fracture classification, intra-operative and post-operative complications, time to mobilisation and union, AOFAS and Olerud-Molander scores, and patient mobility were recorded. RESULTS: There were seven males and thirteen females, with a mean age of 77.82 years old, five of whom are type 2 diabetics. Thirteen patients returned to their pre-operative mobility state, and the average Charlson Co-morbidity Index (CCI) was 5.05. Patients with a low CCI are more likely to return to pre-operative mobility status (p = 0.16; OR = 4.00). All patients achieved radiographical union, taking on average between 92.5 days and 144.6 days. The mean post-operative AOFAS and Olerud-Molander scores were 53.0 and 50.9, respectively. There were four cases of superficial infection, four cases of broken or loose distal locking screws. There were no deep infections, periprosthetic fractures, nail breakages, or non-unions. CONCLUSION: Tibiotalocalcaneal nailing is an effective and safe option for managing unstable ankle fractures in the elderly. This technique leads to lower complication rates and earlier mobilisation than traditional fixation methods.
dc.identifier.doi10.17863/CAM.78448
dc.identifier.eissn1432-1068
dc.identifier.issn1633-8065
dc.identifier.urihttps://www.repository.cam.ac.uk/handle/1810/331003
dc.language.isoeng
dc.publisherSpringer Science and Business Media LLC
dc.rightsAll rights reserved
dc.rights.urihttp://www.rioxx.net/licenses/all-rights-reserved
dc.titleAnkle fusion with tibiotalocalcaneal retrograde nail for fragility ankle fractures: outcomes at a major trauma centre.
dc.typeArticle
dcterms.dateAccepted2021-11-15
prism.publicationNameEur J Orthop Surg Traumatol
rioxxterms.licenseref.startdate2021-11-15
rioxxterms.licenseref.urihttp://www.rioxx.net/licenses/all-rights-reserved
rioxxterms.typeJournal Article/Review
rioxxterms.versionAM
rioxxterms.versionofrecord10.1007/s00590-021-03171-1

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