Fixation of unstable ankle fractures using a long hindfoot nail

Baker, Gordon J.; Mayne, Alistair; Andrews, C.

doi:10.1016/j.injury.2018.07.028

Cited by 24 publications

(34 citation statements)

References 9 publications

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“…Otros autores sugieren que el clavo debe alcanzar la tuberosidad tibial anterior. 8 Burns y Dunse 9 hallaron que la longitud estándar del clavo corto incrementa la fuerza en la cortical posterior de la tibia a nivel del bloqueo proximal unas 5,3 veces más que un clavo largo bloqueado. Por esto, muchos usan un clavo endomedular largo para una fijación y estabilidad mejores, en la diáfisis, reduciendo el estrés y la posibilidad de fractura.…”

Section: Discussionunclassified

Versatilidad del clavo endomedular retrógrado largo de tibia para artrodesis tibio-talocalcánea en pacientes con lesiones asociadas en el mismo segmento

Alberti

Carabelli

Verbner

et al. 2021

Rev. Asoc. Arg. Ort. y Traumatol

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Introducción: La afección articular que lleva a la necesidad de una artrodesis tibio-calcánea puede estar acompañada de una segunda lesión en el mismo segmento óseo, y los clavos de diseño para artrodesis no tienen la longitud adecuada para cubrir ambas lesiones. No hallamos opciones terapéuticas para este tipo de lesiones en la bibliografía. Objetivo: Presentar una serie de casos en los que se utilizó un único clavo de tibia (de colocación anterógrada) de forma retrógrada, con el doble objetivo de efectuar una artrodesis tibio-talo-calcánea, sumada al tratamiento de una lesión asociada en un mismo tiempo quirúrgico. Materiales y Métodos: Se evaluó, en forma retrospectiva, desde septiembre de 2009 hasta junio de 2019, a un grupo de 12 pacientes que requirió una artrodesis tibio-talo-calcánea sumada a la necesidad de resolver simultáneamente un defecto secundario local. La edad promedio fue de 43.7 años, y el seguimiento global fue de 43.9 meses. Resultados: Todos los pacientes lograron una artrodesis tibio-calcánea constatada en radiografías de frente y de perfil, y el 83,3% recuperó el stock óseo de manera completa. Conclusión: Ante la ausencia en el mercado de osteosíntesis para resolver las patologías asociadas en un mismo paciente, proponemos el uso del clavo endomedular largo de tibia colocado de manera retrógrada como una opción de tratamiento, porque se ha demostrado que es eficaz para lograr la artrodesis tibio-calcánea. Además, se lo pudo utilizar como guía en el alargamiento y el transporte óseo, y como estabilización para tratar lesiones simultáneas.

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Section: Discussionunclassified

Versatilidad del clavo endomedular retrógrado largo de tibia para artrodesis tibio-talocalcánea en pacientes con lesiones asociadas en el mismo segmento

Alberti

Carabelli

Verbner

et al. 2021

Rev. Asoc. Arg. Ort. y Traumatol

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“…Since 2005, 10 studies have been published on the treatment of these fractures with retrograde TTC nailing (Table 4). Most of these studies reported satisfactory functional results and low complication rates (9)(10)(11)(12)(13)(14)(15)(16)(17)(18) . In 2005, Lemon et al (9) published the first article on this technique: a case series of 12 patients (mean age, 84 years; follow-up, 67 weeks), achieving good functional results and early full weight bearing in all patients.…”

Section: Discussionmentioning

confidence: 99%

“…Functional outcome did not differ between the groups (TTC nailing vs ORIF), but the rates of complications, hospital stay, and mortality were lower in the nailing group. In 2018, Baker et al (16) published a retrospective study of 16 patients with 3 or more comorbidities and unstable ankle fractures. Overall, the results were good, especially the low rate of wound complications and early recovery.…”

Section: Discussionmentioning

confidence: 99%

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Acute retrograde tibiotalocalcaneal nailing in osteoporotic periarticular ankle fractures

et al. 2020

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Objective: This study aimed to report the short-term results of retrograde tibiotalocalcaneal (TTC) nailing in a selected series of patients with fragility ankle fractures. Methods: This study included 17 patients who underwent primary retrograde TTC nailing from January 2016 to April 2019. The Olerud-Molander ankle score (OMAS) was recorded preoperatively and at the final follow-up. Results: Mean patient age was 81.5 years (range, 67-91 years), and mean follow-up duration was 20.9 months (range, 8-50 months). No patient was lost to follow-up. Eleven patients had diabetes. Thirteen patients were able to walk with an assistive device, and 4 with help from another person. Two patients died at 8 and 9 months after treatment. Radiographic healing was observed in 100% of the fractures. No deep infection or scarring problems were recorded. Two patients were wheelchair bound after treatment, whereas 15 recovered their previous autonomy. The mean OMAS score changed from 64.1 (range, 55-75) preoperatively to 55.3 (range, 45-65) postoperatively. Conclusion: Our results suggest that primary retrograde TTC nailing is a valid option in selected patients with fragility ankle fractures, multiple comorbidities, poor soft tissue condition, and difficulty in walking before the fracture. Level of Evidence IV; Therapeutic Studies, Case Series.

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“…This modality is also contraindicated when soft tissue is poor in many elderly patients [10]. Therefore, various minimally invasive approaches have been investigated, including extraperiosteal plating, a long hindfoot nail, the minimally invasive percutaneous plate osteosynthesis (MIPPO), and provisional external fixation [5,[11][12][13][14]. McAndrew found that the application of the external fixator might be effective for trimalleolar fracture [15].…”

Section: Introductionmentioning

confidence: 99%

Effects and Anti-rotation Stabilization of the Non-bridging External Fixation for Pronation-Abduction Stage III Ankle Fracture: A Cadaveric Study

Chen

Huang

Cheng

et al. 2021

BioMed Research International

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Objective. This study is aimed at providing a nonbridging external fixation technique with pinning fixation for the pronation-abduction stage III ankle fracture. The secondary purpose was to evaluate its effect on anatomic reduction and fracture fragment stability against cadaveric models’ rotation. Method. A paired design study was conducted using 14 pairs of the cadaveric model which had been modeled for pronation-abduction stage III ankle fracture. One fracture model from each pair was randomly allocated to receive an open reduction and internal fixation, while the other was reduced and stabilized with the external fixation technique. After the surgery, the antirotational stability tests were performed with external rotation torques of 10 nm, 15 nm, and 20 nm applied, respectively. The postoperation reduction rate and ankle parameters were recorded in anteroposterior and lateral radiographs before and after the antirotational stability experiment. Result. The outcomes were assessed according to Burwell-Charnley’s radiographic criteria of reduction. It showed no statistically significant differences in reduction between the two groups ( P < 0.05 ). The displacement of lateral fragment following a reduction in the external fixation group was significantly larger than that of the internal fixation group ( 3.14 ± 0.56 vs. 1.49 ± 0.39 , P < 0.05 ). After applying rotational torques of 10 nm, 15 nm, and 20 nm, the results of other parameters showed no significant differences between the two groups. Conclusion. This nonbridging external fixation method with pin fixation of fracture fragments might have the same effect as that of internal fixation on the reduction rate of pronation-abduction stage III ankle fracture.

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Fixation of unstable ankle fractures using a long hindfoot nail

Cited by 24 publications

References 9 publications

Versatilidad del clavo endomedular retrógrado largo de tibia para artrodesis tibio-talocalcánea en pacientes con lesiones asociadas en el mismo segmento

Versatilidad del clavo endomedular retrógrado largo de tibia para artrodesis tibio-talocalcánea en pacientes con lesiones asociadas en el mismo segmento

Acute retrograde tibiotalocalcaneal nailing in osteoporotic periarticular ankle fractures

Effects and Anti-rotation Stabilization of the Non-bridging External Fixation for Pronation-Abduction Stage III Ankle Fracture: A Cadaveric Study

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