ReviewEFORT open reviews2022
Retrograde tibiotalocalcaneal nailing for the treatment of acute ankle fractures in the elderly: a systematic review and meta-analysis.
Review in EFORT open reviews, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers, 1 of them a synthesis that pooled it.
What it found
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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.
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.
Who cites it
14 citing papers in PubMed, 1 synthesis or guideline pooled it, 21 citations in OpenAlex.
- Formal joint preparation appears to not be necessary for surgical treatment of ankle fractures with tibiotalocalcaneal nailing: a systematic review.European journal of orthopaedic surgery & traumatology : orthopedie traumatologie · 2026Pooled it
- Reaming-induced joint surface destruction in tibiotalocalcaneal nailing: a cadaveric comparison of straight and valgus-curved nails.Journal of orthopaedic surgery and research · 2026Article
- The Diagnosis, Treatment, and Aftercare of Ankle Fractures.Deutsches Arzteblatt international · 2026Review
- Percutaneous Tibiotalocalcaneal Nailing in Fragility Ankle Fractures of the Elderly: A Single-Center Case Series.Cureus · 2025Article
- Article
- An overview on the management of ankle fractures in elderly patients aged 65 and over: a scoping review.European journal of orthopaedic surgery & traumatology : orthopedie traumatologie · 2025Article
- Tibiotalar Nailing for Geriatric Pilon Fractures: Case Report and Review of the Literature.Journal of orthopaedic case reports · 2025Article
- Tibiotalocalcaneal arthrodesis using retrograde nailing (TTCAN) in post-traumatic conditions with high septic risk. Clinical experience.International orthopaedics · 2025Observational
- Biomechanical design considerations of a 3D-printed tibiotalocalcaneal nail for ankle joint fusion.3D printing in medicine · 2025Article
- The Impact of Diabetes on Outcomes for Tibiotalocalcaneal Arthrodesis: A Systematic Review of Available Comparative Studies.Healthcare (Basel, Switzerland) · 2025Review
- Complications and Early-Term Radiographic Analysis of a Novel Active Compression Tibiotalocalcaneal Arthrodesis Nail With a Proximal Flexible Coil.Foot & ankle orthopaedics · 2025Article
- Surgical Management of Complex Ankle Fractures in Patients with Diabetes: A National Retrospective Multicentre Study.Journal of clinical medicine · 2024Article
- The outcomes of the management of complex distal tibia and ankle fractures in elderly with tibiotalocalcaneal nail in a minimum 12-month follow-up period.European journal of orthopaedic surgery & traumatology : orthopedie traumatologie · 2024Article
- Ankle fractures in the elderly: Do we have new concepts?EFORT open reviews · 2023Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Introduction: Fragility ankle fractures are traditionally managed conservatively or with open reduction internal fixation. Tibiotalocalcaneal (TTC) nailing is an alternative option for the geriatric patient. This meta-analysis provides the most detailed analysis of TTC nailing for fragility ankle fractures. Methods: A systematic search was performed on MEDLINE, EMBASE, Cochrane Library, and Web of Science, identifying 14 studies for inclusion. Studies including patients with a fragility ankle fracture, defined according to NICE guidelines as a low-energy fracture obtained following a fall from standing height or less, that were treated with TTC nail were included. Patients with a previous fracture of the ipsilateral limb, fibular nails, and pathological fractures were excluded. This review was registered in PROSPERO (ID: CRD42021258893). Results: A total of 312 ankle fractures were included. The mean age was 77.3 years old. In this study, 26.9% were male, and 41.9% were diabetics. The pooled proportion of superficial infection was 10% (95% CI: 0.06-0.16), deep infection 8% (95% CI: 0.06-0.11), implant failure 11% (95% CI: 0.07-0.15), malunion 11% (95% CI: 0.06-0.18), and all-cause mortality 27% (95% CI: 0.20-0.34). The pooled mean post-operative Olerud-Molander ankle score was 54.07 (95% CI: 48.98-59.16). Egger's test (P = 0.56) showed no significant publication bias. Conclusion: TTC nailing is an adequate alternative option for fragility ankle fractures. However, current evidence includes mainly case series with inconsistent post-operative rehabilitation protocols. Prospective randomised control trials with long follow-up times and large cohort sizes are needed to guide the use of TTC nailing for ankle fractures.
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