Abstract
Osteoporotic fragility fractures of the ankle in the elderly present a difficult challenge for the orthopaedic surgeon. There is a high incidence of complications with both operative and non-operative treatment. We have treated nine such fractures by closed reduction and percutaneous ankle stabilisation using a transarticular Gallagher nail introduced via the calcaneum and directed through the talar dome into the tibia. The median patient age was 81 years (range 60–101 years). Mean duration of patient follow-up was 34 months. All the fractures maintained satisfactory alignment and healed without delay. Pain-free transfer with assistance was possible in all patients by 8 weeks post-operatively. Nails were removed in eight patients. Six patients returned to pre-fracture mobility status. Union was achieved in eight cases. No wound complications occurred. Gallagher nail percutaneous trans-calcaneal stabilisation provides a means of sole definitive fixation in the management of unstable osteoporotic ankle fractures in the elderly.
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