Ankle fractures are common injuries and the third most common fragility fracture. In all, 40% of ankle fractures in the frail are open and represent a complex clinical scenario, with morbidity and mortality rates similar to hip fracture patients. They have a higher risk of complications, such as wound infections, malunion, hospital-acquired infections, pressure sores, veno-thromboembolic events, and significant sarcopaenia from prolonged bed rest. A modified Delphi method was used and a group of experts with a vested interest in best practice were invited from the British Foot and Ankle Society (BOFAS), British Orthopaedic Association (BOA), Orthopaedic Trauma Society (OTS), British Association of Plastic & Reconstructive Surgeons (BAPRAS), British Geriatric Society (BGS), and the British Limb Reconstruction Society (BLRS).Aims
Methods
To report our early experience and suitability over unicortical fixation system to reduce and hold the bone fragments in position during a CHAOS procedure of the femur or tibia during lower limb reconstruction surgery. We report a case series of the first consecutive 10 patients (11 bones) for which this CHAOS technique was used between May 2017 and October 2019 by the same surgeon. The novel aspect of the procedure was the use of a unicortical device, Galaxy UNYCO (Orthofix, Verona, Italy), which eliminate the need for any change of fixation during the procedure. It also means the intramedullary canal was left free for the intramedullary nailing.Introduction
Materials and Methods
Kappa scores for the components of the score were 0.403 for the lateral condyle; 0.492 for the trochlea; 0.354 for the proximal radius and 0.508 for the olecranon. Adding item scores to produce a modified Sauvegrain score had an intra-class reliability of 0.858 (95% CI 0.758 to 0.935).