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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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
Subjects:
Online Access:https://www.jojs.in/doi/JOJS/pdf/10.5005/jojs-10079-1205
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author Sudipta Samanta
Soumyadeep D Roy
author_facet Sudipta Samanta
Soumyadeep D Roy
author_sort Sudipta Samanta
collection DOAJ
description 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.
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spelling doaj-art-5d8e1044bbf34439b043950fb93e8ba02025-08-20T04:02:27ZengJaypee Brothers Medical PublisherJournal of Orthopedics and Joint Surgery2582-78632025-07-017228228910.5005/jojs-10079-120521Outcome of Hindfoot Nail in Old Distal Tibia and Plafond Fractures of Adult Patients in a Tertiary Care CenterSudipta Samanta0https://orcid.org/0000-0001-8956-5275Soumyadeep D Roy1https://orcid.org/0000-0001-9201-8432Sudipta Samanta, Department of Orthopedics, Nil Ratan Sircar Medical College and Hospital, Kolkata, West Bengal, India, Phone: +91 9477328634Department of Orthopedics, Nil Ratan Sircar Medical College and Hospital, Kolkata, West Bengal, IndiaBackground: 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.https://www.jojs.in/doi/JOJS/pdf/10.5005/jojs-10079-1205ankle arthrodesisdistal tibia fractureshindfoot nailnonunionplafond fracture
spellingShingle Sudipta Samanta
Soumyadeep D Roy
Outcome of Hindfoot Nail in Old Distal Tibia and Plafond Fractures of Adult Patients in a Tertiary Care Center
Journal of Orthopedics and Joint Surgery
ankle arthrodesis
distal tibia fractures
hindfoot nail
nonunion
plafond fracture
title Outcome of Hindfoot Nail in Old Distal Tibia and Plafond Fractures of Adult Patients in a Tertiary Care Center
title_full Outcome of Hindfoot Nail in Old Distal Tibia and Plafond Fractures of Adult Patients in a Tertiary Care Center
title_fullStr Outcome of Hindfoot Nail in Old Distal Tibia and Plafond Fractures of Adult Patients in a Tertiary Care Center
title_full_unstemmed Outcome of Hindfoot Nail in Old Distal Tibia and Plafond Fractures of Adult Patients in a Tertiary Care Center
title_short Outcome of Hindfoot Nail in Old Distal Tibia and Plafond Fractures of Adult Patients in a Tertiary Care Center
title_sort outcome of hindfoot nail in old distal tibia and plafond fractures of adult patients in a tertiary care center
topic ankle arthrodesis
distal tibia fractures
hindfoot nail
nonunion
plafond fracture
url https://www.jojs.in/doi/JOJS/pdf/10.5005/jojs-10079-1205
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