Percutaneous Gallagher nail stabilisation for fragility ankle fracture

OʼDaly, Brendan J.; Harty, James; O’Malley, Natasha T.; O’Rourke, S. K.; Quinlan, W.

doi:10.1007/s00590-010-0629-1

Cited by 7 publications

(24 citation statements)

References 16 publications

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“…In the same year, Persigant et al (17) published the results of a series of 14 patients treated with a retrograde femoral nail and immediate weight bearing, with a mean follow-up of 12 months. O´Daly 2010 (11) RT The authors reported satisfactory functional results, fracture union, and only 1 major complication (deep infection requiring nail removal). Finally, in 2019, Ebaugh et al (18) published a retrospective study of 27 patients with complicated diabetes treated with TTC nailing and reported high functional and limb salvage rates, few complications, and maintenance of the previous level of autonomy.…”

Section: Discussionmentioning

confidence: 91%

“…However, over the past 10 years, interest has grown in the use of TTC nailing as a treatment option for unstable fractures in selected patients. Based on data from the literature and our own experience, retrograde TTC nailing as a method of osteosynthesis in unstable osteoporotic periarticular ankle fractures in frail patients with difficulty in walking without assistance is a highly satisfactory technique (9)(10)(11)(12) .…”

Section: Discussionmentioning

confidence: 99%

“…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%

“…In 2008, Amirfeyz et al (10) published a retrospective study of 13 patients (mean age, 79 years; follow-up, 11 months) and reported early hospital discharge, functional outcome comparable to the preoperative status, fracture healing, and no complications; however, the inclusion criteria were not well defined. In 2010, O'Daly et al (11) published a series of 9 cases treated with TTC nailing after failure of conservative treatment with closed manipulation. Fracture union was observed in 89%, and 70% of patients returned to their previous functional status without any complication.…”

Section: Discussionmentioning

confidence: 99%

“…Tibiotalocalcaneal (TTC) nailing has been a valid treatment option for osteoporotic ankle fractures in the acute phase. Several studies have been published since 2005 with satisfactory functional results in selected patients, with a low rate of complications (9)(10)(11)(12)(13)(14)(15)(16)(17)(18) .…”

Section: Introductionmentioning

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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Section: Discussionmentioning

confidence: 91%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Acute retrograde tibiotalocalcaneal nailing in osteoporotic periarticular ankle fractures

et al. 2020

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An overview on the treatment and outcome factors of ankle fractures in elderly men and women aged 80 and over: a systematic review

Halsema

Boers

Leferink

2021

Arch Orthop Trauma Surg

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Introduction This article is a systematic review of the literature on elderly aged 80 and over with an ankle fracture. Low energy trauma fractures are a major public health burden in developed countries that have aged populations. Ankle fractures are the third most common fractures after hip and wrist fractures. The purpose of this review is to provide an overview of the treatments and the used outcome factors. Methods PubMed, Embase, Cochrane Library, and CINAHL were searched to retrieve relevant studies. Studies published in English or Dutch concerning the treatment of ankle fractures in patients aged 80 and over were included. Results Initially 2054 studies were found in the databases. After removing duplicate entries, 1182 remained. Finally, after screening six studies were included, of which three cohorts studies and three case series. Six different treatments were identified and described; ORIF, transarticular Steinmann pin, plaster cast with or without weight-bearing, Gallagher nail and the TCC nail. Furthermore, 32 outcome factors were identified. Discussion The various studies show that practitioners are careful with early weight-bearing. However, if we look closely to the results and other literature, this seems not necessary and it could potentially be of great value to implement early weight-bearing in the treatment. Furthermore, quality of life seems underreported in this research field. Conclusions ORIF with plaster cast and permissive weight-bearing should be considered for this population since it seems to be a safe possibility for a majority of the relatively healthy patients aged 80 and over. In cases where surgery is contra-indicated and a plaster cast is the choice of treatment, early weight-bearing seems to have a positive influence on the outcome in the very old patient.

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Ankle fusion with tibiotalocalcaneal retrograde nail for fragility ankle fractures: outcomes at a major trauma centre

Tennyson

Zhang

et al. 2021

Eur J Orthop Surg Traumatol

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Purpose Fragility ankles fractures in the geriatric population are challenging to manage, due to fracture instability, soft tissue compromise, and patient co-morbidities. Traditional management options include open reduction internal fixation, or conservative treatment, both of which are fraught with high complication rates. We aimed to present functional outcomes of elderly patients with fragility ankle fractures treated with retrograde ankle fusion nails. Methods A retrospective observational study was performed on patients who underwent intramedullary nailing with a tibiotalocalcaneal nail. Twenty patients met the inclusion criteria of being over sixty and having multiple co-morbidities. Patient demographics, AO/OTA fracture classification, intra-operative and post-operative complications, time to mobilisation and union, AOFAS and Olerud-Molander scores, and patient mobility were recorded. Results There were seven males and thirteen females, with a mean age of 77.82 years old, five of whom are type 2 diabetics. Thirteen patients returned to their pre-operative mobility state, and the average Charlson Co-morbidity Index (CCI) was 5.05. Patients with a low CCI are more likely to return to pre-operative mobility status (p = 0.16; OR = 4.00). All patients achieved radiographical union, taking on average between 92.5 days and 144.6 days. The mean post-operative AOFAS and Olerud-Molander scores were 53.0 and 50.9, respectively. There were four cases of superficial infection, four cases of broken or loose distal locking screws. There were no deep infections, periprosthetic fractures, nail breakages, or non-unions. Conclusion Tibiotalocalcaneal nailing is an effective and safe option for managing unstable ankle fractures in the elderly. This technique leads to lower complication rates and earlier mobilisation than traditional fixation methods.

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Percutaneous Gallagher nail stabilisation for fragility ankle fracture

Cited by 7 publications

References 16 publications

Acute retrograde tibiotalocalcaneal nailing in osteoporotic periarticular ankle fractures

Acute retrograde tibiotalocalcaneal nailing in osteoporotic periarticular ankle fractures

An overview on the treatment and outcome factors of ankle fractures in elderly men and women aged 80 and over: a systematic review

Ankle fusion with tibiotalocalcaneal retrograde nail for fragility ankle fractures: outcomes at a major trauma centre

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