Abstract
Purpose: To demonstrate that Rush pin is safe and effective in selected fragility ankle fractures.
Introduction: Fragility ankle fracture is increasing proportionately to their age. It produces not only clinical challenge due to multiple co morbidities but also a challenge to heal the fracture and particularly the skin. We found that early minimal intervention by stabilizing the lateral column with a rush nail is safe, beneficial and acceptable practice in selected cases.
Material & Method: Retrospective case notes & X-rays review of fragility ankle fractures between 1st of January 2005 to 31st of August 2008 selection using the criteria below
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✓ Closed Ankle Fracture
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✓ Elderly or fragility fracture
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✓ Minimal invasive ORIF
Results:
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Seven patients found.
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Mean age: 78.2
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M: F – 1:5
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ASA CLASS: 3–4
All patients had ankle fracture with fragile or damaged skin. All operated within 10 days of injury, including those who were on warfarin or significant medical problems. All underwent closed reduction and or percutaneous medial malleolar fixation and stabilization of the lateral column with Rush Pin through a stab incision under x-ray control. A lightweight plaster was applied for 4–6 weeks. All fracture healed in a acceptable position without any skin complication. One patient who had pre operative ulcer also healed.
Discussion/Conclusion: Minimally invasive treatment has no surgical wound complication. All fracture healed in a satisfactory position. All discharged after mean follow up of 6 month. One death due to unrelated cause after 5 weeks of operation.
Rush pin fixation in fragility fracture is a useful and safe methods of treatment in selected group.
Correspondence should be addressed to BOSA at the Royal College of Surgeons, 35–43 Lincoln’s Inn Fields, London WC2A 3PE, England.
