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    "description": "PurposeFragility ankles fractures in the geriatric population are challenging to manage, due to fracture instability, soft tissue compromise, and patient co-morbidities. Traditional management options include open reduction internal fixation, or conservative treatment, both of which are fraught with high complication rates. We aimed to present functional outcomes of elderly patients with fragility ankle fractures treated with retrograde ankle fusion nails.\nMethodsA retrospective observational study was performed on patients who underwent intramedullary nailing with a tibiotalocalcaneal nail. Twenty patients met the inclusion criteria of being over sixty and having multiple co-morbidities. Patient demographics, AO/OTA fracture classification, intra-operative and post-operative complications, time to mobilisation and union, AOFAS and Olerud-Molander scores, and patient mobility were recorded.\nResultsThere were seven males and thirteen females, with a mean age of 77.82\u00a0years old, five of whom are type 2 diabetics. Thirteen patients returned to their pre-operative mobility state, and the average Charlson Co-morbidity Index (CCI) was 5.05. Patients with a low CCI are more likely to return to pre-operative mobility status (p\u2009=\u20090.16; OR\u2009=\u20094.00). All patients achieved radiographical union, taking on average between 92.5\u00a0days and 144.6\u00a0days. The mean post-operative AOFAS and Olerud-Molander scores were 53.0 and 50.9, respectively. There were four cases of superficial infection, four cases of broken or loose distal locking screws. There were no deep infections, periprosthetic fractures, nail breakages, or non-unions.ConclusionTibiotalocalcaneal nailing is an effective and safe option for managing unstable ankle fractures in the elderly. This technique leads to lower complication rates and earlier mobilisation than traditional fixation methods.", 
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        "name": "European Journal of Orthopaedic Surgery & Traumatology", 
        "publisher": "Springer Nature", 
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    "keywords": [
      "Charlson co-morbidity index", 
      "fragility ankle fractures", 
      "Olerud-Molander score", 
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      "open reduction internal fixation", 
      "co-morbidity index", 
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      "retrospective observational study", 
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      "type 2 diabetics", 
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      "unstable ankle fractures", 
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      "soft tissue compromise", 
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      "elderly patients", 
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      "superficial infection", 
      "trauma center", 
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      "ankle fusion", 
      "geriatric population", 
      "tissue compromise", 
      "nail breakage", 
      "observational study", 
      "inclusion criteria", 
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      "patients", 
      "locking screws", 
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      "days", 
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      "demographics", 
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      "cases", 
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      "females", 
      "rate", 
      "status", 
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      "compromise", 
      "fusion", 
      "classification", 
      "time", 
      "breakage", 
      "Union", 
      "instability", 
      "technique", 
      "method", 
      "state", 
      "mobility", 
      "mobility state"
    ], 
    "name": "Ankle fusion with tibiotalocalcaneal retrograde nail for fragility ankle fractures: outcomes at a major trauma centre", 
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