Ankle fractures in elderly persons with severe osteopenia and/or pre-existing medical
conditions such as diabetes and asthma/chronic obstructive pulmonary disease (COPD)
pose difficult problems. Rigid fixation of these fractures in elderly patients is
often technically difficult due to comminution at the site of the fracture and osteoporosis.
It is also associated with a high risk of complications such as skin break-down, infection,
failed fixation, and generally yields poor results.
2
Management of failed primary fixation in such patients is a greater orthopaedic challenge.
We report four cases of osteoporotic ankle fractures with failed primary fixation,
which have been salvaged using an ankle arthrodesis nail. In all four cases, a good
clinical result has been achieved with successful radiological fusion.To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to InjuryAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Ankle fractures in elderly: non-operative or operative treatment.J Orthop Trauma. 1987; 1: 275-280
- Ankle fractures in elderly: MUA versus ORIF.Injury. 1993; 24: 116-120
- Malleolar fractures: non-operative versus operative treatment: a controlled study.Clin Orthop. 1985; 199: 17-27
- Displaced ankle fractures in patients over 50 years of age.J Bone Joint Surg (Br). 1983; 65: 329-332
- A biomechanical comparison of intramedullary nail and crossed lag screw fixation for tibiotalocalcaneal arthrodesis.Foot Ankle Int. 1997; 18: 639-643
- Intramedullary rod fixation compared with blade-plate- and screw fixation for tibiocalcaneal arthrodesis: a biomechanical investigation.J Bone Joint Surg. 2003; 85A: 2425-2428
- Complications of ankle and tibiotalocalcaneal arthrodesis.Clin Orthop. 2001; 391: 33-34
- Operative treatment of ankle fractures using internal osteosynthesis by a minimal surgical approach.The Foot. 2004; 14: 185-191
- Tibiotalocalcaneal arthrodesis with intramedullary interlocking nail fixation.Clin Podiatr Med Surg. 2000; 17: 19-31
- Intramedullary nailing in tibitalocalcaneal arthrodesis.Unfallichirurg. 2003; 106: 633-641
Howard BB, James WB, Kenneth AS. Complications following intramedullary tibiotalocalcaneal arthrodesis. AOFAS Summer Meeting 2001.
- Epidemiology of osteoporotic ankle fractures in elderly patients in Finland.Ann Int Medicine. 1996; 125: 975-978
- Operative treatment of ankle fracture dislocations.Clin Orthop. 1985; 199: 28-38
- The treatment of unstable fractures of the ankle in the elderly.Injury. 1987; 18: 128-132
- Conservative versus operative treatment for displaced ankle fractures in patients over 55 years of age: a prospective randomised study.J Bone Joint Surg (Br). 2001; 83: 525-529
- Ankle fractures treated with AO principle: an experience with 116 cases.Injury. 1985; 16: 265-272
- J Foot Ankle Surg. 2004; 43: 82-86
- Retrograde intramedullary nailing for ankle artrodesis.Foot Ankle Int. 1995; 16: 433-436
- Bi and trimalleolar ankle fractures operated with non-rigid internal fixation.Clin Orthop. 1986; 206: 253-260
- Pantalar and tibiotalocalcaneal arthrodesis for post-traumatic osteoarthritis of the ankle and hindfoot.J Bone Joint Surg Am. 1992; 74: 1042-1049
- A charcot ankle fusion with a retrograde locked intramedullary nail.Foot Ankle Int. 1997; 18: 699-704
- Tibiotalocalcaneal arthrodesis.Tech Orthop. 1996; 11: 269-273
- The role of fibular nail in the management of Weber B ankle fractures in elderly patients with osteoporotic bone: a preliminary report.Injury. 2001; 32: 477-478
- Surgical correction of severe deformities of rheumatoid hindfoot.Tech Orthop. 2003; 18: 297-302
Article info
Publication history
Accepted:
August 17,
2005
Identification
Copyright
© 2005 Elsevier Ltd. Published by Elsevier Inc. All rights reserved.
ScienceDirect
Access this article on ScienceDirectLinked Article
- Salvage of osteoporotic ankle fractures after failed primary fixation with an ankle arthrodesis nail: A report on four casesInjuryVol. 38Issue 5
- PreviewWe read with interest the case series titled “Salvage of osteoporotic ankle fractures after failed primary fixation with an ankle arthrodesis nail: A report on four cases” by Houshian et al. in the August edition.2 As the authors correctly state, these fragility fractures are difficult to treat due to poor bone and soft tissue quality. Our approach to the treatment of these fractures is with an expandable retrograde calcaneo-talar-tibial nail as both primary treatment and revision of failed internal fixation.
- Full-Text
- Preview
- Salvage of osteoporotic ankle fractures after failed primary fixation with an ankle arthrodesis nail: A report of four casesInjuryVol. 38Issue 5
