{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T11:14:58Z","timestamp":1783509298539,"version":"3.55.0"},"reference-count":35,"publisher":"MDPI AG","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,5]]},"abstract":"<jats:p>\n                    <jats:bold>Background:<\/jats:bold>\n                    Management of tibial pilon fracture in elderly patients with psychiatric illness remains challenging for orthopedic doctors because of patients\u2019 poor bone quality and inability for self-care. This study aimed to ascertain the viability and reliability of primary arthrodesis by using retrograde hindfoot nail for these difficult cases.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Methods:<\/jats:bold>\n                    We retrospectively reviewed eight elderly consecutive patients (age older than 65 years) with tibial pilon fractures and psychiatric illness from January of 2012 to December of 2019 in our institute. Primary tibiotalocalcaneal arthrodesis with retrograde hindfoot nail was used as a definitive procedure. The bone union time, wound complication rate, ankle alignment, necessity for narcotic agents, and ambulation status were evaluated.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Results:<\/jats:bold>\n                    The average length of follow-up was 22.25 months (range, 15\u201336 months). Additional bone grafting surgery was performed for one patient because of fusion-site nonunion 6 months postoperatively. Another patient required debridement and removal of posterior calcaneal screw because of implant prominence and local infection. Osseous union with angular deformity less than 10\u00b0 was achieved in all patients finally. The average bone union time was 6.6 months (range, 4\u201312 months). In terms of walking ability, six patients were capable of outdoor ambulation (classes 2 and 3). Two patients required oral pain medication at the final visit.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Conclusions:<\/jats:bold>\n                    The current study involved only a small number of patients, and two of the eight cases encountered undesired complications (one local infection and one bone nonunion); however, we believe that our method may serve as a valuable alternative for the treatment of tibial pilon fractures in elderly patients with psychiatric illness, considering the specificity of this fragile population.\n                  <\/jats:p>","DOI":"10.7547\/22-048","type":"journal-article","created":{"date-parts":[[2024,7,26]],"date-time":"2024-07-26T08:39:18Z","timestamp":1721983158000},"source":"Crossref","is-referenced-by-count":1,"title":["Primary Arthrodesis with Retrograde Hindfoot Nail for Elderly Patients with Tibia Pilon Fractures and Psychiatric Illness"],"prefix":"10.3390","volume":"114","author":[{"given":"Yen-Chun","family":"Chiu","sequence":"first","affiliation":[{"name":"E-Da Hospital, I-Shou University, Orthopaedic Department, Jiau-Shu Tsuen, Yan-Chau Shiang, Kaohsiung City, Taiwan."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chin-Hsien","family":"Wu","sequence":"additional","affiliation":[{"name":"E-Da Hospital, I-Shou University, Orthopaedic Department, Jiau-Shu Tsuen, Yan-Chau Shiang, Kaohsiung City, Taiwan."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kun-Ling","family":"Tsai","sequence":"additional","affiliation":[{"name":"National Cheng Kung University, Tainan City, Taiwan."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"I-Ming","family":"Jou","sequence":"additional","affiliation":[{"name":"E-Da Hospital, I-Shou University, Orthopaedic Department, Jiau-Shu Tsuen, Yan-Chau Shiang, Kaohsiung City, Taiwan."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuan-Kun","family":"Tu","sequence":"additional","affiliation":[{"name":"E-Da Hospital, I-Shou University, Orthopaedic Department, Jiau-Shu Tsuen, Yan-Chau Shiang, Kaohsiung City, Taiwan."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ching-Hou","family":"Ma","sequence":"additional","affiliation":[{"name":"E-Da Hospital, I-Shou University, Orthopaedic Department, Jiau-Shu Tsuen, Yan-Chau Shiang, Kaohsiung City, Taiwan."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","reference":[{"key":"B1","series-title":"J Orthop Trauma","first-page":"530","article-title":"Open reduction and internal fixation of tibial pilon fractures using a lateral approach","volume":"21","author":"Grose A","year":"2007","unstructured":"Grose A, Gardner MJ, Hettrich C, et al: Open reduction and internal fixation of tibial pilon fractures using a lateral approach. 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