Ankle Fractures That Act Like Hip Fractures, and a New Treatment for Them
The unusual debate about tibiotalocalcaneal nails for ankle fractures in older patients
![Ankle Fractures That Act Like Hip Fractures, and a New Treatment for Them](/content/images/size/w1200/2024/04/Ghost-banner-image--9-.png)
What’s the Claim?
Since you may hear from thought leaders in the world of foot and ankle trauma on the topic we're covering here this week, this post will be about a debate as much as an article. Their recommendation may turn out to be right, but we want you to have a clear sense of what we know on this topic.
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
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’ conclusion was: “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?