ICYMI: A New Treatment For Open Ankle Fractures (Which Act More Like Hip Fractures) in Older Patients
This debate — and the recommendation that seems to be arising from it — surprised us, and we think it will be helpful to you
What’s the Claim?
A case series reported on 34 older patients (ages 73 to 99) who were treated with a long tibiotalocalcaneal (TTC) nail — think pantalar fusion but without joint preparation for arthrodesis — and primary wound closure for open ankle fractures.
- 56% of these patients worsened in terms of their mobility status
- Nearly 80% were discharged somewhere other than home after the hospital stay
- 6% of the patients died within 3 months
Those numbers sound more like hip fracture numbers than ankle fracture numbers — all the more so, considering that the authors don’t report a minimum follow-up duration and don’t say how many patients were lost to follow-up before some reasonable minimum period.
Despite all that, the authors concluded: “Use of a tibiotalocalcaneal nail with primary wound closure offers a reasonable treatment option for open fractures of the ankle in the elderly patient.”
- What could justify such a viewpoint?
