Tibiotalocalcaneal nailing as a treatment for ankle fractures in the elderly population: A systematic review

This study evaluated patient outcomes of tibiotalocalcaneal (TTC) nailing for ankle fractures in an elderly population. A systematic literature search of PubMed and Google Scholar identified 24 studies involving 657 patients aged over 65. Key outcome measures included union rates, healing time, functional scores, and complications. The average union rate for TTC nail patients was 88.36 % (±12 %), with a healing time of 17.8 weeks (±4.68). Post-operatively, 77.16 % (±17 %) of patients returned to or exceeded their baseline ambulatory function. Pre-injury Olerud-Molander Ankle Scores averaged 63.1 (±5.00), compared to 50.43 (±8.59) post-surgery. Infection rates were reported in 10.51 % (±0.07) of patients (60/571), with superficial and deep infection rates of 6.83 % (±8 %) and 3.68 % (±6 %), respectively. Nail failure occurred in 4.7 % (12/255) of cases, and the average revision rate was 13.36 % (±7 %). In conclusion, TTC nailing is a viable treatment for elderly patients with ankle fractures. It offers satisfactory functional outcomes and an acceptable complication risk. It is particularly beneficial for those unable to undergo multiple surgeries or with significant comorbidities, providing a quick and effective means to restore mobility.