Distal Femoral Nail as a Cost-Effective Alternative to Tibiotalocalcaneal Nail for Ankle Fracture Non-Union in an Elderly Patient: A Case Report

Introduction: Ankle fracture non-union in elderly patients is challenging due to osteoporotic bone, comorbidities, and risks associated with open reduction and internal fixation (ORIF). Tibiotalocalcaneal (TTC) nail fixation enables early weight-bearing but is costly and not widely available in reso...

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Main Authors: Pawan Kumar, Abhishek Kumar Das, Sudarsan Behera, Manish Raj, Janki Sharan Bhadani, Baibhav Mishra
Format: Article
Language:English
Published: Indian Orthopaedic Research Group 2025-03-01
Series:Journal of Orthopaedic Case Reports
Subjects:
Online Access:https://jocr.co.in/wp/2025/03/01/distal-femoral-nail-as-a-cost-effective-alternative-to-tibiotalocalcaneal-nail-for-ankle-fracture-non-union-in-an-elderly-patient-a-case-report/
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author Pawan Kumar
Abhishek Kumar Das
Sudarsan Behera
Manish Raj
Janki Sharan Bhadani
Baibhav Mishra
author_facet Pawan Kumar
Abhishek Kumar Das
Sudarsan Behera
Manish Raj
Janki Sharan Bhadani
Baibhav Mishra
author_sort Pawan Kumar
collection DOAJ
description Introduction: Ankle fracture non-union in elderly patients is challenging due to osteoporotic bone, comorbidities, and risks associated with open reduction and internal fixation (ORIF). Tibiotalocalcaneal (TTC) nail fixation enables early weight-bearing but is costly and not widely available in resource-limited settings. Case Report: We present an 83-year-old male with a painful, deformed left ankle and non-union of a bimalleolar fracture treated conservatively. Comorbidities included diabetes mellitus and hypertension. Due to fragile skin and high ORIF-associated risks, a distal femoral nail (DFN) was used as a substitute for a TTC nail. A minimally invasive technique was performed, including joint preparation and medial malleolar bone grafting. Weight-bearing was initiated postoperatively. Conclusion: DFN offered comparable fixation with reduced cost and acceptable complications. This case highlights DFN’s utility as a TTC nail substitute in elderly patients, ensuring stability, early mobilization, and functional recovery in low-resource settings.
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institution Kabale University
issn 2250-0685
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language English
publishDate 2025-03-01
publisher Indian Orthopaedic Research Group
record_format Article
series Journal of Orthopaedic Case Reports
spelling doaj-art-7d2cddefbc35458495ea1dd181f224d32025-08-20T03:31:27ZengIndian Orthopaedic Research GroupJournal of Orthopaedic Case Reports2250-06852321-38172025-03-0115316516810.13107/jocr.2025.v15.i03.5374Distal Femoral Nail as a Cost-Effective Alternative to Tibiotalocalcaneal Nail for Ankle Fracture Non-Union in an Elderly Patient: A Case ReportPawan KumarAbhishek Kumar DasSudarsan BeheraManish RajJanki Sharan BhadaniBaibhav MishraIntroduction: Ankle fracture non-union in elderly patients is challenging due to osteoporotic bone, comorbidities, and risks associated with open reduction and internal fixation (ORIF). Tibiotalocalcaneal (TTC) nail fixation enables early weight-bearing but is costly and not widely available in resource-limited settings. Case Report: We present an 83-year-old male with a painful, deformed left ankle and non-union of a bimalleolar fracture treated conservatively. Comorbidities included diabetes mellitus and hypertension. Due to fragile skin and high ORIF-associated risks, a distal femoral nail (DFN) was used as a substitute for a TTC nail. A minimally invasive technique was performed, including joint preparation and medial malleolar bone grafting. Weight-bearing was initiated postoperatively. Conclusion: DFN offered comparable fixation with reduced cost and acceptable complications. This case highlights DFN’s utility as a TTC nail substitute in elderly patients, ensuring stability, early mobilization, and functional recovery in low-resource settings.https://jocr.co.in/wp/2025/03/01/distal-femoral-nail-as-a-cost-effective-alternative-to-tibiotalocalcaneal-nail-for-ankle-fracture-non-union-in-an-elderly-patient-a-case-report/distal femur nailankle arthrodesisosteoporotic fracture
spellingShingle Pawan Kumar
Abhishek Kumar Das
Sudarsan Behera
Manish Raj
Janki Sharan Bhadani
Baibhav Mishra
Distal Femoral Nail as a Cost-Effective Alternative to Tibiotalocalcaneal Nail for Ankle Fracture Non-Union in an Elderly Patient: A Case Report
Journal of Orthopaedic Case Reports
distal femur nail
ankle arthrodesis
osteoporotic fracture
title Distal Femoral Nail as a Cost-Effective Alternative to Tibiotalocalcaneal Nail for Ankle Fracture Non-Union in an Elderly Patient: A Case Report
title_full Distal Femoral Nail as a Cost-Effective Alternative to Tibiotalocalcaneal Nail for Ankle Fracture Non-Union in an Elderly Patient: A Case Report
title_fullStr Distal Femoral Nail as a Cost-Effective Alternative to Tibiotalocalcaneal Nail for Ankle Fracture Non-Union in an Elderly Patient: A Case Report
title_full_unstemmed Distal Femoral Nail as a Cost-Effective Alternative to Tibiotalocalcaneal Nail for Ankle Fracture Non-Union in an Elderly Patient: A Case Report
title_short Distal Femoral Nail as a Cost-Effective Alternative to Tibiotalocalcaneal Nail for Ankle Fracture Non-Union in an Elderly Patient: A Case Report
title_sort distal femoral nail as a cost effective alternative to tibiotalocalcaneal nail for ankle fracture non union in an elderly patient a case report
topic distal femur nail
ankle arthrodesis
osteoporotic fracture
url https://jocr.co.in/wp/2025/03/01/distal-femoral-nail-as-a-cost-effective-alternative-to-tibiotalocalcaneal-nail-for-ankle-fracture-non-union-in-an-elderly-patient-a-case-report/
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AT abhishekkumardas distalfemoralnailasacosteffectivealternativetotibiotalocalcanealnailforanklefracturenonunioninanelderlypatientacasereport
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AT jankisharanbhadani distalfemoralnailasacosteffectivealternativetotibiotalocalcanealnailforanklefracturenonunioninanelderlypatientacasereport
AT baibhavmishra distalfemoralnailasacosteffectivealternativetotibiotalocalcanealnailforanklefracturenonunioninanelderlypatientacasereport