The Role of Free Tissue Transfers for Defect Coverage over the Body in Geriatric Populations.

The treatment of soft tissue defects in multimorbid frail patients requires optimized preoperative and perioperative management with a differentiated interdisciplinary approach. Preoperative assessment with established scores, such as the ASA score, is important in order to stratify the operative complication risk. Following the reconstructive ladder is important to avoid unnecessary long operations and consecutively higher operative risks.

Tibiotalocalcaneal Intramedullary Nailing for Unstable Geriatric Ankle Fractures.

Background: Tibiotalocalcaneal (TTC) intramedullary nailing has been suggested as an alternative to open reduction and internal fixation (ORIF) for the primary treatment of unstable fragility ankle fractures with a poor soft tissue envelope. This study aims to investigate the clinical efficacy of TTC intramedullary nail fixation for the primary treatment of unstable ankle fractures in frail elderly patients with poor soft tissue condition, by assessing the number of postoperative complications and the patient-reported functional outcomes.

Methods: A retrospective cohort study was performed including patients with an unstable ankle fracture treated between 2015 and 2019 with TTC stabilization using a retrograde intramedullary hindfoot nail that was inserted without joint preparation and allowing immediate weight-bearing postoperatively.