Novel Technique for Reduction of Ankle Valgus Malunion and Chronic Talus Subluxation during Hindfoot Nailing
In recent years, there has been a significant increase in the incidence and severity of ankle fractures in the elderly. We present a case of an elderly patient with significant medical comorbidities and social issues who sustained an unstable ankle fracture that led to a severe malunion secondary to...
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| Format: | Article |
| Language: | English |
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Wiley
2020-01-01
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| Series: | Case Reports in Orthopedics |
| Online Access: | http://dx.doi.org/10.1155/2020/8826714 |
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| author | Matthew Ciminero Kevin Kang Amr Abdelgawad |
| author_facet | Matthew Ciminero Kevin Kang Amr Abdelgawad |
| author_sort | Matthew Ciminero |
| collection | DOAJ |
| description | In recent years, there has been a significant increase in the incidence and severity of ankle fractures in the elderly. We present a case of an elderly patient with significant medical comorbidities and social issues who sustained an unstable ankle fracture that led to a severe malunion secondary to refusal for surgery and noncompliance with weight-bearing precautions. By choosing an intramedullary fixation method that can be inserted through a biologically advantageous surgical exposure, we can permit early mobilization, create a stable plantigrade foot for ambulation, and alleviate the expected noncompliance with weight-bearing precautions in this patient. Despite debridement of callus, fibular osteotomy, and plate-assisted reduction, a displaced valgus angulation of the ankle joint remained. The nail was removed then reinserted backwards with the bend directed medially instead of its normal lateral position in order to use the bend in the nail as a reduction aid to finalize the reduction. We feel this technique may be of assistance to future surgeons encountering a similar situation. |
| format | Article |
| id | doaj-art-c1435626d48342abbd369dcd47c519a2 |
| institution | DOAJ |
| issn | 2090-6749 2090-6757 |
| language | English |
| publishDate | 2020-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Case Reports in Orthopedics |
| spelling | doaj-art-c1435626d48342abbd369dcd47c519a22025-08-20T03:23:30ZengWileyCase Reports in Orthopedics2090-67492090-67572020-01-01202010.1155/2020/88267148826714Novel Technique for Reduction of Ankle Valgus Malunion and Chronic Talus Subluxation during Hindfoot NailingMatthew Ciminero0Kevin Kang1Amr Abdelgawad2Maimonides Medical Center, Brooklyn, NY, USAMaimonides Medical Center, Brooklyn, NY, USAMaimonides Medical Center, Brooklyn, NY, USAIn recent years, there has been a significant increase in the incidence and severity of ankle fractures in the elderly. We present a case of an elderly patient with significant medical comorbidities and social issues who sustained an unstable ankle fracture that led to a severe malunion secondary to refusal for surgery and noncompliance with weight-bearing precautions. By choosing an intramedullary fixation method that can be inserted through a biologically advantageous surgical exposure, we can permit early mobilization, create a stable plantigrade foot for ambulation, and alleviate the expected noncompliance with weight-bearing precautions in this patient. Despite debridement of callus, fibular osteotomy, and plate-assisted reduction, a displaced valgus angulation of the ankle joint remained. The nail was removed then reinserted backwards with the bend directed medially instead of its normal lateral position in order to use the bend in the nail as a reduction aid to finalize the reduction. We feel this technique may be of assistance to future surgeons encountering a similar situation.http://dx.doi.org/10.1155/2020/8826714 |
| spellingShingle | Matthew Ciminero Kevin Kang Amr Abdelgawad Novel Technique for Reduction of Ankle Valgus Malunion and Chronic Talus Subluxation during Hindfoot Nailing Case Reports in Orthopedics |
| title | Novel Technique for Reduction of Ankle Valgus Malunion and Chronic Talus Subluxation during Hindfoot Nailing |
| title_full | Novel Technique for Reduction of Ankle Valgus Malunion and Chronic Talus Subluxation during Hindfoot Nailing |
| title_fullStr | Novel Technique for Reduction of Ankle Valgus Malunion and Chronic Talus Subluxation during Hindfoot Nailing |
| title_full_unstemmed | Novel Technique for Reduction of Ankle Valgus Malunion and Chronic Talus Subluxation during Hindfoot Nailing |
| title_short | Novel Technique for Reduction of Ankle Valgus Malunion and Chronic Talus Subluxation during Hindfoot Nailing |
| title_sort | novel technique for reduction of ankle valgus malunion and chronic talus subluxation during hindfoot nailing |
| url | http://dx.doi.org/10.1155/2020/8826714 |
| work_keys_str_mv | AT matthewciminero noveltechniqueforreductionofanklevalgusmalunionandchronictalussubluxationduringhindfootnailing AT kevinkang noveltechniqueforreductionofanklevalgusmalunionandchronictalussubluxationduringhindfootnailing AT amrabdelgawad noveltechniqueforreductionofanklevalgusmalunionandchronictalussubluxationduringhindfootnailing |