BOFAS Abstracts Archive

You can search for abstracts by using the search bar below.
Alternatively you can browse through podium and poster presentations by selecting the year and / or type below. You can further refine your search using tags or use the search bar.

Search

RSS Abstracts 476 Expand/Collapse
- RSS 2013 64 Expand/Collapse
  - RSS Poster 24 Expand/Collapse
  - RSS Podium 40 Expand/Collapse
- RSS 2014 36 Expand/Collapse
  - RSS Podium 36 Expand/Collapse
- RSS 2015 49 Expand/Collapse
  - RSS Poster 20 Expand/Collapse
  - RSS Podium 29 Expand/Collapse
- RSS 2016 45 Expand/Collapse
  - RSS Poster 18 Expand/Collapse
  - RSS Podium 27 Expand/Collapse
- RSS 2017 40 Expand/Collapse
  - RSS Poster 15 Expand/Collapse
  - RSS Podium 25 Expand/Collapse
- RSS 2018 47 Expand/Collapse
  - RSS Poster 22 Expand/Collapse
  - RSS Podium 25 Expand/Collapse
- RSS 2019 48 Expand/Collapse
  - RSS Poster 25 Expand/Collapse
  - RSS Podium 23 Expand/Collapse
- RSS 2021 15 Expand/Collapse
  - RSS Poster 10 Expand/Collapse
  - RSS Podium 6 Expand/Collapse
- RSS 2022 46 Expand/Collapse
  - RSS Poster 23 Expand/Collapse
  - RSS Podium 23 Expand/Collapse
- RSS 2023 46 Expand/Collapse
  - RSS Poster 23 Expand/Collapse
  - RSS Podium 23 Expand/Collapse
- RSS 2024 40 Expand/Collapse
  - RSS Poster 18 Expand/Collapse
  - RSS Podium 22 Expand/Collapse

Categories: Abstracts, 2023, Podium

HARnT-2 hindfoot nail or pro-tibial screw fixation for early mobilisation: multi-centre comparative study of utilisation & outcomes in complex ankle fractures

J. Bethel, A.-A. Najefi, M. Davies, E. Gosney, K. Patel, R. Ahluwalia

¹King’s College Hospital, London, Orthopaedics, London, United Kingdom

Introduction: Hindfoot intramedullary nail fixation (HFN) or fibula pro-tibial screw fixation (PTS) are surgical options for ankle fractures in patients with multiple co-morbidities; we compared their outcomes.

Methods: A retrospective review of 135 patients who underwent HFN fixation (87 patients) or PTS fixation (48 patients) for ankle fractures (AO/OTA A/B/C) from 5 major trauma centres. Patient demographic data, co-morbidities, Charlson Co-morbidity Index Score (CCIS), weight-bearing, and post-operative complications were recorded. Radiographs were assessed for non-union and anatomical reduction.

Results: HFN estimated 10-year survival was 27±31% and was 48±37% for PTS (p<0.001). Average time to full weightbearing (FWB) in the HFN group was 1.7±3.3 weeks compared to 7.8±3.8 weeks in the PTS group (p<0.001). Despite this, HFN fixation carried a greater VTE risk (p=0.02). HFN accompanied by joint preparation had greater risk of infection (p=0.01), metalwork failure (p=0.02) and wound breakdown (p=0.01). The overall complication rate in diabetic patients was 56%, but 76% in HFN patients. In the HFN group 17 (20%) patients died at 1 year. Patients with open fractures(p=0.01), dementia (p<0.05), and a higher CCIS (p=0.04) were more likely to die after HFN surgery. Age and co-morbidity matched data showed a higher rate of complications and mortality in those above 75 years fixed with a HFN, irrespective of CCIS. In those between 60-75 years, there was a greater risk of superficial infection and mortality after HFN, irrespective of CCIS. These complications were not seen after PTS.

Conclusion: HFN carries a greater risk of superficial infections, VTE and mortality compared to PTS, independent of age and CCIS. Diabetes leads to a greater comparative risk of deep infections, wound breakdown and non-union in HFN. Alternative methods of fixation (e.g. PTS) should be considered before HFN. HFN may be suitable in selective indications where other methods are not appropriate.

Print

Tags: Ankle Fracture Hindfoot Trauma

Documents to download

HARnT-2 hindfoot nail or pro-tibial screw fixation for early mobilisation: multi-centre comparative study of utilisation & outcomes in complex ankle fractures(.pdf, 240.32 KB) - 248 download(s)

Click thumbnail below to view poster / thumbnail:

Archive of Abstracts