• Foot Ankle Surg · Aug 2018

    Tibiotalocalcaneal nail fixation and soft tissue coverage of Gustilo-Anderson grade 3B open unstable ankle fractures in a frail population; a case series in a major trauma centre.

    • Lesley Armstrong, John Jackson, and Andrew Riddick.
    • Southmead Hospital, Southmead Road, Westbury-on-Trym, Bristol BS10 5NB, United Kingdom. Electronic address: lesley.armstrong@doctors.org.uk.
    • Foot Ankle Surg. 2018 Aug 1; 24 (4): 347-352.

    BackgroundGustilo-Anderson grade 3B open ankle fracture-dislocations requiring stable fixation and soft tissue coverage are increasingly common in frail populations.MethodsWe identified all patients with open ankle fracture-dislocations treated with a tibiotalocalcaneal nail and soft tissue coverage over a five-year period. We retrospectively recorded pre-morbid status, fracture and soft tissue injury pattern, surgical details, post-operative mobility, length of hospital stay, complication and re-operation rate and survival.Results21 ankles (20 patients) are included, all grade 3B open fractures. All patients were permitted to mobilise by one to six weeks post-surgery. One patient required further soft tissue surgery. Six patients had superficial wound colonization/infection, none developed deep infections. None of the nails have required removal. We observed a 15% three-month mortality rate.ConclusionTibiotalocalcaneal nail fixation and soft tissue coverage of unstable open ankle fractures in frail patients facilitates early return to ambulation with a low complication and re-operation rate.Copyright © 2017 European Foot and Ankle Society. Published by Elsevier Ltd. All rights reserved.

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