Outcomes of a newly developed solid posterior offset tibiotalocalcaneal intramedullary nail in the treatment of traumatic, unstable fragility ankle fractures

Abstract PURPOSE: The primary aim of this study was to evaluate outcomes following tibiotalocalcaneal arthrodesis using a solid posterior offset hindfoot arthrodesis nail in the management of unstable fragility ankle fractures. METHODS: Design: Retrospective case series. Setting: A single academic tertiary referral centre in the west of Ireland. Patient Selection Criteria: Patients over the age of 50 with an unstable fragility ankle fracture treated with a solid posterior offset hindfoot arthrodesis nail in our institution were included. Outcome Measures and Comparisons: Clinical and radiological outcomes were examined preoperatively, and at three and six months postoperatively. Pre- and postoperative functional status was assessed with the Olerud and Molander (O&M) score. Patients were followed up at six months and two years postoperatively. RESULTS: A total of six patients met inclusion criteria and were included. All patients achieved clinical and radiological union by the six-month follow-up. Three out of six of patients returned to baseline mobility, and four of six patients had no pain at the six-month follow-up. On average, O&M scores were 64 preoperatively, 48 at six-month follow-up, and 56 at two-year follow-up. One patient experienced superficial wound infection and was treated with antibiotics. No other significant complications occurred. CONCLUSIONS : This small case series has demonstrated that tibiotalocalcaneal arthrodesis with a solid posterior offset hindfoot arthrodesis nail is a safe and effective procedure that can be used in the management of unstable fragility ankle fractures. It demonstrated a low complication rates and good functional outcomes in our cohort at two-year follow-up. LEVEL OF EVIDENCE: Therapeutic Level IV