Utility of external fixation for traumatic periprosthetic fracture after total ankle arthroplasty in patients with rheumatoid arthritis: A report of two cases

Gensuke Okamura; Takaaki Noguchi; Yuki Etani; Kosuke Ebina; Seiji Okada; Jun Hashimoto; Makoto Hirao

doi:10.1093/mrcr/rxae084

Utility of external fixation for traumatic periprosthetic fracture after total ankle arthroplasty in patients with rheumatoid arthritis: A report of two cases

Mod Rheumatol Case Rep. 2024 Dec 14:rxae084. doi: 10.1093/mrcr/rxae084. Online ahead of print.

Authors

Gensuke Okamura¹, Takaaki Noguchi², Yuki Etani², Kosuke Ebina², Seiji Okada², Jun Hashimoto³, Makoto Hirao¹

Affiliations

¹ Department of Orthopaedic Surgery, National Hospital Organization, Osaka Minami Medical Center, Osaka, Japan.
² Department of Orthopaedic Surgery, Osaka University Graduate School of Medicine, Osaka, Japan.
³ Department of Orthopaedic Surgery, Kashimoto Hospital, Osaka, Japan.

PMID: 39673769
DOI: 10.1093/mrcr/rxae084

Abstract

This report describes two cases of implant-stable traumatic periprosthetic fractures after total ankle arthroplasty (TAA) in patients with rheumatoid arthritis (RA). One case with low body mass index (BMI) [14 kg/m2] achieved complete bone union with the use of an external fixator, while the other case with a high BMI [32.83 kg/m2] failed to achieve bone union with the external fixator; however, complete union was achieved utilizing secondary internal plate fixation. Although open reduction and internal fixation using a plate is the standard procedure in implant-stable periprosthetic fracture cases, fixation using an external fixator might be suitable for patients with RA with low body weight and low BMI, from the perspective of preventing surgical site complications.

Keywords: external fixation; internal fixation; tibial diaphysis; total ankle arthroplasty (TAA); traumatic periprosthetic fracture.

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