Management of traumatic periprosthetic total ankle replacement fractures: A case report involving long-stemmed tibial components

Traumatic periprosthetic fractures around total ankle replacements (TARs) are not well documented in the literature, with less than 13 total cases described. These injuries present reconstructive challenges to the treating surgeon. TAR usage continues to rise, and thus traumatic periprosthetic ankle fractures will likely become more frequent. Current literature discussing the classification, treatment, and outcomes of this pathology is lacking and mostly discusses intra-operative and or stress fractures. The authors retrospectively reviewed 419 patients sustaining ankle fractures at a level 1 trauma center. Two (0.004 %) patients suffered a traumatic periprosthetic ankle fracture and were treated operatively via minimally invasive open reduction internal fixation (ORIF). These patients were followed for a year at the time of publication. Patient outcomes including the union rate, time to union and need for revision were reviewed. Results included 100 % (2/2) fracture union at an average of 5 months. The patients have returned to their pre-operative function level, ambulating unassisted. No re-operations or post-operative complications were noted. To the best of the authors’ knowledge, we report the first case report detailing patient outcomes of post-traumatic periprosthetic fractures after TAR, utilizing the INBONE Total Ankle System ( Wright Medical Group, Memphis, TN).