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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Main Authors: Matthew Ciminero, Kevin Kang, Amr Abdelgawad
Format: Article
Language:English
Published: Wiley 2020-01-01
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.
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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
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AT kevinkang noveltechniqueforreductionofanklevalgusmalunionandchronictalussubluxationduringhindfootnailing
AT amrabdelgawad noveltechniqueforreductionofanklevalgusmalunionandchronictalussubluxationduringhindfootnailing