Outcomes after primary ankle arthrodesis in recent fractures of the distal end of the tibia in the elderly: a systematic review

Fadhel, Wael Ben; Taieb, Léa; Villain, Benoît; Mebtouche, Nasser; Levante, Stéphane; Bégué, Thierry; Aurégan, Jean-Charles

doi:10.1007/s00264-022-05317-0

Cited by 4 publications

(2 citation statements)

References 28 publications

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“…The excision of the lesion may lead to ankle joint loss, necessitating secondary arthrodesis. Arthrodesis is typically employed as a salvage procedure to alleviate pain and maintain ankle stability [14][15]. In our approach, we ensured thorough removal of the infected bone segment and addressed the challenges of remarkable bone defects through the utilization of Ilizarov technology with a unilateral external xator.…”

Section: Discussionmentioning

confidence: 99%

A unilateral external fixator combined with bone transport and tibia-talar fusion for the treatment of severe postoperative infection of peri-ankle fractures

Qinghu,

Xin,

Yonghui

et al. 2023

Preprint

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Background To investigate the clinical effects of a unilateral external fixator combined with bone transport and tibial-talar fusion in the treatment of severe postoperative infection of peri-ankle fractures. Methods The clinical data of 32 patients (22 men and 10 women) with severe postoperative infection of peri-ankle fractures were retrospectively analyzed. Patients’ age ranged from 26 to 62 (mean, 42 ± 9.5) years old. The types of fractures were as follows: distal tibial fracture in 25 cases, distal tibial and fibula fracture in 5 cases, and talus fracture in 2 cases. All patients underwent treatment with unilateral external fixation combined with bone transport and tibia-talar fusion. In the initial stage, 6 patients with severe infection received treatment involving focal debridement and external fixation. In the second stage, they underwent osteotomy and bone transport. The remaining 26 patients underwent debridement, external fixation, and osteotomy simultaneously. The length of bone transport, total fixation time of the external fixator, and postoperative complications were recorded for all patients. The efficacy of the treatment was assessed using the American Association of Foot and Ankle Society (AOFAS) ankle-hindfoot score. Results Patients were followed up for 16–36 months, with an average follow-up time of 24 months. The length of tibial bone transport ranged from 5 to 15 cm, with a mean length of 8.5 cm. The external fixator was applied for 12–24 months, with an average duration of 16 months. One patient experienced a re-fracture of the tibial-talar fusion after the removal of the external fixation, while eventually recovered well. No complications, such as recurrent infection, poor mineralization, refracture, or fusion failure, were found in the remaining patients. The preoperative AOFAS ankle hindfoot function score was 40.0 ± 3.8 (range, 30–52)points, and it increased to 75.0 ± 3.0 (range, 67–78) points at the last follow-up. Conclusion A unilateral external fixator combined with bone transport and tibial-talar fusion is an effective method for treating severe postoperative infection of peri-ankle fractures. This approach is capable of reconstructing large bone defects that remain after clearing the infected lesion. Additionally, it provides stability to the ankle, enhances ankle-hindfoot function, and improves the patient’s quality of life.

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Section: Discussionmentioning

confidence: 99%

A unilateral external fixator combined with bone transport and tibia-talar fusion for the treatment of severe postoperative infection of peri-ankle fractures

Qinghu,

Xin,

Yonghui

et al. 2023

Preprint

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“…These patients are often incapable of partial weightbearing and therefore require a treatment option allowing full weightbearing. A primary arthrodesis of the hindfoot including the ankle and subtalar joint (tibiotalocalcaneal arthrodesis (TTC)) might be a safe option for geriatric patients with a consolidation rate of up to 95% and the advantage of allowing immediate full weightbearing ( 43 ) and a minimal invasive technique with a hindfoot nail. Furthermore, an atypical, closed reduction and insertion of the nail without an open removal of the cartilage is recommended by some authors, as soft tissue-related complications are minimized by this technique ( 44 ).…”

Section: Treatment Optionsmentioning

confidence: 99%

Ankle fractures in the elderly: Do we have new concepts?

2023

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The relevance of geriatric ankle fractures is continuously increasing. Treatment of these patients remains challenging and requires adapted diagnostic and therapeutic strategies, as compliance to partial weight bearing is difficult to maintain compared to younger patients. In addition, in the elderly even low impact injuries may lead to severe soft tissue trauma, influencing timing and operative strategies. Recently, the direct posterolateral approach and plate fixation techniques, angular stable implants as well as intramedullary nailing of the distal fibula have been found to improve stategical concepts. This article aims to provide a comprehensive overview of the diagnostic and recent aspects with respect to how this difficult entity of injuries should be approached.

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Results of Total Ankle Arthroplasty Versus Ankle Arthrodesis

Rodriguez-Merchan,

Moracia-Ochagavia

2024

Foot and Ankle Clinics

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Outcomes after primary ankle arthrodesis in recent fractures of the distal end of the tibia in the elderly: a systematic review

Cited by 4 publications

References 28 publications

A unilateral external fixator combined with bone transport and tibia-talar fusion for the treatment of severe postoperative infection of peri-ankle fractures

A unilateral external fixator combined with bone transport and tibia-talar fusion for the treatment of severe postoperative infection of peri-ankle fractures

Ankle fractures in the elderly: Do we have new concepts?

Results of Total Ankle Arthroplasty Versus Ankle Arthrodesis

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