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Primary ankle arthrodesis for neglected open Weber B ankle fracture dislocation
Katherine Thomason1, Ashwanth Ramesh2, Niall McGoldrick3
1Foot and Ankle Orthopaedic Fellow, Cappagh National Orthopaedic Hospital, Dublin, Ireland.
Summary
Primary ankle fusion is a novel treatment for neglected open ankle fracture dislocations. This approach successfully salvaged a patient
Area of Science:
- Orthopedic Surgery
- Trauma Surgery
- Limb Salvage Procedures
Background:
- Open ankle fracture dislocations present complex challenges in trauma management.
- Neglected cases, especially those with significant soft tissue compromise, often require extensive surgical intervention.
- Traditional management may involve multiple procedures or amputation.
Observation:
- A 63-year-old male presented with a 5-day-old open right ankle fracture dislocation.
- The injury involved significant soft tissue damage requiring debridement.
- Initial management included primary tibiotalar joint arthrodesis with Kirschner wire fixation and external fixation.
Findings:
- Primary ankle arthrodesis was successfully performed in this neglected open fracture dislocation.
- Limb salvage was achieved through fusion consolidation.
- Definitive soft tissue coverage was accomplished using a latissimus dorsi free flap.
Implications:
- This case demonstrates the feasibility of primary ankle arthrodesis for neglected open ankle fracture dislocations.
- This surgical strategy offers a limb-salvage option in complex trauma cases.
- Further research may explore the long-term outcomes of this unique approach.
