Outcome of Hindfoot Nail in Old Distal Tibia and Plafond Fractures of Adult Patients in a Tertiary Care Center

Background: Plafond fractures and distal tibia fractures, especially those resulting from high-energy injury, are often complicated by soft tissue injury and open injuries. They are usually managed in a staged fashion with primary external fixation followed by internal fixation. From prolonged exter...

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Bibliographic Details
Main Authors: Sudipta Samanta, Soumyadeep D Roy
Format: Article
Language:English
Published: Jaypee Brothers Medical Publisher 2025-07-01
Series:Journal of Orthopedics and Joint Surgery
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Online Access:https://www.jojs.in/doi/JOJS/pdf/10.5005/jojs-10079-1205
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Summary:Background: Plafond fractures and distal tibia fractures, especially those resulting from high-energy injury, are often complicated by soft tissue injury and open injuries. They are usually managed in a staged fashion with primary external fixation followed by internal fixation. From prolonged external fixation in anticipation of soft tissue healing, the patients end up with a near-stiff ankle joint and multiple failed attempts at union. Hindfoot nail (HFN) attempts to allow early mobilization of these patients by sound arthrodesis of the near-stiff ankle joint, and the study aims to evaluate the patients in terms of outcome. Materials and methods: This is a prospective study conducted on 30 subjects with old distal tibia and/or plafond fractures over a period of 2 years, and the study subjects were compared in terms of preoperative and postoperative functional, clinical, and radiological parameters. Results: The mean age of our study population was 70 years, with equal male and female distribution (1:1). The mean duration from index injury to HFN was 8.7 months. Statistically significant improvement in the modified Olerud-Molander Ankle Score (mOMAS) was observed when compared preoperatively to 1-month and 6-month follow-up (10.33 ± 7.65 vs 56.5 ± 9.84 vs 73.46 ± 5.43, respectively). The mean limb length discrepancy was 2.71 ± 1.34 cm. A total of 80% of subjects achieved sound arthrodesis of the ankle at the 6th postoperative month. Conclusion: HFN is an effective treatment option.
ISSN:2582-7863