Evidence map›Paper›PMID 34211800›Full record

ArticleGeriatric orthopaedic surgery & rehabilitation2021

Tibiotalocalcaneal Intramedullary Nailing for Unstable Geriatric Ankle Fractures.

Elif Kulakli-Inceleme, David B Tas, Diederik P J Smeeing, Roderick M Houwert, Nicole M van Veelen, Bjoern-Christian Link, Lukas D Iselin, Matthias Knobe, Reto Babst, Frank J P Beeres

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Article in Geriatric orthopaedic surgery & rehabilitation, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.

0numbers the graph read from it
0cells of the map it votes in
8citing papers in PubMed
2.7field-weighted citation impact, top 10% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

8 citing papers in PubMed, 23 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors at 3 institutions in 2 countries.

Elif Kulakli-IncelemeDepartment of Orthopaedic and Trauma Surgery, Luzerner Kantonsspital, Lucerne, Switzerland.
David B TasDepartment of Trauma Surgery, University Medical Center Utrecht, Utrecht, The Netherlands.ORCID https://orcid.org/0000-0002-0060-2605
Diederik P J SmeeingDepartment of Trauma Surgery, Slingeland Hospital, Doetinchem, The Netherlands.
Roderick M HouwertDepartment of Trauma Surgery, University Medical Center Utrecht, Utrecht, The Netherlands.
Nicole M van VeelenDepartment of Orthopaedic and Trauma Surgery, Luzerner Kantonsspital, Lucerne, Switzerland.
Bjoern-Christian LinkDepartment of Orthopaedic and Trauma Surgery, Luzerner Kantonsspital, Lucerne, Switzerland.
Lukas D IselinDepartment of Orthopaedic and Trauma Surgery, Luzerner Kantonsspital, Lucerne, Switzerland.
Matthias KnobeDepartment of Orthopaedic and Trauma Surgery, Luzerner Kantonsspital, Lucerne, Switzerland.
Reto BabstDepartment of Orthopaedic and Trauma Surgery, Luzerner Kantonsspital, Lucerne, Switzerland.
Frank J P BeeresDepartment of Orthopaedic and Trauma Surgery, Luzerner Kantonsspital, Lucerne, Switzerland.
Luzerner Kantonsspital · CHUniversity Medical Center Utrecht · NLSlingeland Ziekenhuis · NL

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundTibiotalocalcaneal (TTC) intramedullary nailing has been suggested as an alternative to open reduction and internal fixation (ORIF) for the primary treatment of unstable fragility ankle fractures with a poor soft tissue envelope. This study aims to investigate the clinical efficacy of TTC intramedullary nail fixation for the primary treatment of unstable ankle fractures in frail elderly patients with poor soft tissue condition, by assessing the number of postoperative complications and the patient-reported functional outcomes.

methodsA retrospective cohort study was performed including patients with an unstable ankle fracture treated between 2015 and 2019 with TTC stabilization using a retrograde intramedullary hindfoot nail that was inserted without joint preparation and allowing immediate weight-bearing postoperatively. The primary outcome was the total number of postoperative complications.

resultsA total of 10 patients were included out of 365 operatively treated ankle fractures. The mean age was 85.2 years (range 66-92) with a mean follow-up of 11.2 months (range 6-16). Fracture types included AO/OTA 44-B2 (n = 1), 44-B3 (n = 6), 44-C1 (n = 2) and 44-C3 (n = 1). Postoperative complications were observed in 4 patients (40%), including 3 nonunions, 2 implant related complications and 1 wound infection. No wound healing disorder or below-the-knee amputation was observed. Four patients (40%) deceased between post-operative 6 to 16 months due to medical conditions unrelated to surgery. The mean Foot and Ankle Outcome Score was 52.6 (range 44.2-73.8).

conclusionHindfoot nailingis a viable treatment option in selected high-risk patients with an advanced age, unstable ankle fractures with significant bone loss, poor soft tissue condition and/or severely impaired pre-injury mobility. In a frail geriatric population, hindfoot nailing may be a safe alternative fixation method with a low risk of wound complication or major amputation. However, unprepared joint may lead to symptomatic nonunion after TTC intramedullary nailing.

Indexed as

fracturehindfoot nailingintramedullary nailretrospective cohorttibiotalocalcanealunstable ankle

Identifiers

PMID34211800
PMCPMC8216405
OpenAlexW3175828768

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