Osteosynthesis and Trauma Care 2007; 15(4): 150-154
DOI: 10.1055/s-2008-1004793
Original Article

© Georg Thieme Verlag Stuttgart · New York

Stabilization of Ankle Fragility Fractures with a Transtibiocalcaneal Fusion Nail

T. T. Lögters1 , M. Hakimi1 , S. Thelen1 , J. Windolf1 , W. Linhart1
  • 1Department of Trauma- and Hand Surgery, University Hospital Düsseldorf, Germany
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11. Juni 2008 (online)


Introduction: Incidence of ankle fractures in the elderly population increased for the last years. Osteoporosis, compromised soft tissue conditions, vascular supply, and systemic diseases enhance the high demands on fracture management. Here, early results of ankle fracture fixation with transtibiocalcaneal arthrodesis in elderly patients are reported. Patient and methods: Five patients with an unstable ankle fracture were included into this prospective study. All of them underwent closed reduction and transtibiocalcaneal arthrodesis by intramedullary nailing (Hindfoot Fusion Nail, Trigen, smith & nephew). Cartilage of tibiotalar and subtalar joint was left intact. Postoperatively early mobilisation with full weight bearing in a Vacoped® boot was allowed. Results: The mean age of patients was 76 ± 11 years (range: 74-87). There were no intraoperative complications. One patient showed postoperatively a heel ulcer with subsequent superficial infection at a screw entry point, which requires screw removal. Postoperative radiographics before and after mobilisation revealed satisfactory reduction results and sufficient arthrodesis without secondary dislocation for all patients. Conclusion: Arthrodesis of unstable ankle fractures with transtibiocalcaneal intramedullary nailing allows immediate return to full weight bearing and has a low risk of complications. Therefore Hindfoot nail arthrodesis of ankle fractures might be appropriate particularly for patients with severe comorbidities, poor bone stock, and reduced tissue conditions.


W. LinhartMD 

Department of Trauma and Hand Surgery · University Hospital Düsseldorf

Moorenstraße 5

40225 Düsseldorf


eMail: Wolfgang.Linhart@uni-duesseldorf.de