Journal
FOOT AND ANKLE SURGERY
Volume 24, Issue 4, Pages 347-352Publisher
ELSEVIER SCIENCE BV
DOI: 10.1016/j.fas.2017.03.015
Keywords
Ambulation; Frail elderly; Intramedullary nailing; Open fracture; Orthopaedic surgery; Soft tissue injuries; Survival rate
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Background: Gustilo-Anderson grade 3B open ankle fracture-dislocations requiring stable fixation and soft tissue coverage are increasingly common in frail populations. Methods: We identified all patients with open ankle fracture-dislocations treated with a tibiotalocalcaneal nail and soft tissue coverage over a five-year period. We retrospectively recorded pre-morbid status, fracture and soft tissue injury pattern, surgical details, post-operative mobility, length of hospital stay, complication and re-operation rate and survival. Results: 21 ankles (20 patients) are included, all grade 3B open fractures. All patients were permitted to mobilise by one to six weeks post-surgery. One patient required further soft tissue surgery. Six patients had superficial wound colonization/infection, none developed deep infections. None of the nails have required removal. We observed a 15% three-month mortality rate. Conclusion: Tibiotalocalcaneal nail fixation and soft tissue coverage of unstable open ankle fractures in frail patients facilitates early return to ambulation with a low complication and re-operation rate. (C) 2017 European Foot and Ankle Society. Published by Elsevier Ltd. All rights reserved.
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