Management and Treatment Strategies for Distal Tibia and Ankle Infections: Our Clinical Experience

Area of Science:

• Orthopedic Surgery
• Infectious Disease Management
• Trauma Care

Background:

• Distal tibia and ankle infections pose significant surgical challenges due to complex anatomy and high complication rates.
• Effective management requires specialized strategies for infection control and functional restoration.

Purpose of the Study:

• To present clinical experience in managing distal tibia and ankle osteoarticular infections.
• To evaluate surgical strategies, infection control, and functional outcomes over a minimum 24-month follow-up.

Main Methods:

• Retrospective case series of 17 patients with distal tibia/ankle infections (Jan 2020 - May 2023).
• Employed a staged surgical approach: debridement, external fixation, antibiotic-loaded cement spacers.
• Assessed functional outcomes using EQ-5D-5L scores.

Main Results:

• High prevalence of male patients (76.5%), elevated BMI, and comorbidities.
• Open fractures were the most common cause (64.7%); Staphylococcus aureus was the most frequent pathogen (41.2%).
• Achieved 94.1% limb salvage (16/17 patients), despite 58.8% overall complications and 52.9% reinterventions.

Conclusions:

• A tailored, multidisciplinary approach is crucial for managing complex distal tibia and ankle infections.
• Meticulous surgical planning and proactive complication management are key to optimizing patient outcomes.