Abstract
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.
Key words
Ankle fracture - osteoporosis - arthrodesis - injury - Hindfoot Fusion nail
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W. LinhartMD
Department of Trauma and Hand Surgery · University Hospital Düsseldorf
Moorenstraße 5
40225 Düsseldorf
Germany
Email: Wolfgang.Linhart@uni-duesseldorf.de
