ArticleJournal of orthopaedic case reports2025
Distal Femoral Nail as a Cost-Effective Alternative to Tibiotalocalcaneal Nail for Ankle Fracture Non-Union in an Elderly Patient: A Case Report.
Article in Journal of orthopaedic case reports, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Introduction: Ankle fracture non-union in elderly patients is challenging due to osteoporotic bone, comorbidities, and risks associated with open reduction and internal fixation (ORIF). Tibiotalocalcaneal (TTC) nail fixation enables early weight-bearing but is costly and not widely available in resource-limited settings. Case Report: We present an 83-year-old male with a painful, deformed left ankle and non-union of a bimalleolar fracture treated conservatively. Comorbidities included diabetes mellitus and hypertension. Due to fragile skin and high ORIF-associated risks, a distal femoral nail (DFN) was used as a substitute for a TTC nail. A minimally invasive technique was performed, including joint preparation and medial malleolar bone grafting. Weight-bearing was initiated postoperatively. Conclusion: DFN offered comparable fixation with reduced cost and acceptable complications. This case highlights DFN's utility as a TTC nail substitute in elderly patients, ensuring stability, early mobilization, and functional recovery in low-resource settings.
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