859 A Single Center Retrospective Study Comparing Retrograde TibioTaloCalcaneal Nailing vs Open Reduction Internal Fixation of Ankle Fractures in a Comorbid Elderly Population

Abstract

Abstract Aim The aim of this paper is to compare the functional outcomes and complication rates of ankle fractures treated with retrograde tibiotalocalcaneal nail (TTC) and open reduction internal fixation (ORIF). Method Matched cohorts according to age and Charlson Comorbidities Index (CCI) (mean=6) were established by performing a retrospective search of a prospectively collated Bluespier® database for patients within our unit who underwent TTC nailing and open reduction internal fixation (ORIF) for acute trauma from 2015 to 2021. Results 32 patients (8 males/ 24 females) were identified in both the TTC and ORIF groups with mean ages of 78.4 (55–96) and 78.3 (52–93) respectively. Mean follow-up length was 6 months in both groups. All fractures were classified according to AO classification. 3.1% of fractures were 44A, 71.9% 44B, 25% 44C in the TTC group compared to 3.1% 44A, 59.4% 44B and 37.5% 44C fractures in the ORIF group. Surgical site infection rate was 9.4% in the TTC group compared to 6.3% in the ORIF group. Both groups had a similar implant failure rate of 9.4%. 2/32 (6.3%) suffered from periprosthetic fractures in the TTC group and 1 of them required re-operation. 45% of patients in the TTC group returned to their pre-injury level of mobility compared to 40.6% in the ORIF group at their last follow up. Conclusions Our study showed that retrograde TTC nailing can be a useful treatment option for ankle fractures in the comorbid elderly, restoring function and enabling return to full weight bearing immediately after surgery.