{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T11:15:05Z","timestamp":1783509305619,"version":"3.55.0"},"reference-count":13,"publisher":"MDPI AG","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,1]]},"abstract":"<jats:p>Recently there has been expanded interest in the management of fractures of the ankle in the elderly. This case presentation demonstrates an alternative treatment choice for bilateral distal tibial fractures in a comorbid patient. This is a novel case of interest because low-energy bilateral distal tibial fracture in the elderly and comorbid population is a relatively infrequent occurrence. Several case series have demonstrated the efficacy and safety of closed retrograde nailing of distal tibial fractures. The patient was an 80-year-old woman with a medical history that included hypertension, hyperlipidemia, type 2 diabetes, rheumatoid arthritis, chronic obstructive pulmonary disease, coronary artery disease status post stenting, heart failure with preserved ejection fracture, chronic kidney disease, and a history of a transient ischemic attack. The patient\u2019s case was further complicated by the presence of preexisting long-stem bilateral knee prostheses. The patient had been living independently when she experienced a ground-level fall in which imaging showed bilateral distal tibial fractures. The decision to perform closed bilateral concomitant stabilization via retrograde intramedullary nails was based on the need for early ambulation, stability, and the presence of extensive preexisting tibial prostheses. Ultimately, the patient healed uneventfully, returning to a similar level of independence and ambulation as before her injury.<\/jats:p>","DOI":"10.7547\/22-099","type":"journal-article","created":{"date-parts":[[2025,3,24]],"date-time":"2025-03-24T09:32:12Z","timestamp":1742808732000},"source":"Crossref","is-referenced-by-count":0,"title":["Bilateral Distal Tibial Fractures with Preexisting Long-Stem Knee Prostheses Treated with Closed Retrograde Intramedullary Nails: A Case Report"],"prefix":"10.3390","volume":"115","author":[{"given":"Ryan","family":"Lerch","sequence":"first","affiliation":[{"name":"Department of Orthopedic Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeffrey","family":"Manway","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","reference":[{"key":"B1","article-title":"Centers for Disease Control and Prevention: Life expectancy","year":"2016","unstructured":"Centers for Disease Control and Prevention: Life expectancy. Available at: https:\/\/www.cdc.gov\/nchs\/fastats\/life-expectancy.htm. November 29, 2016. Accessed March 31, 2017."},{"key":"B2","series-title":"Statistical Brief #6: Hospitalizations in the Elderly Population, 2003","author":"Russo CA","year":"2006","unstructured":"Russo CA, Elixhauser A: Statistical Brief #6: Hospitalizations in the Elderly Population, 2003. Rockville, MD: Agency for Healthcare Research and Quality; 2006. Available at: http:\/\/www.hcup-us.ahrq.gov\/reports\/statbriefs\/sb6.pdf. November 9, 2014. Accessed March 31, 2017."},{"key":"B3","series-title":"Home and Recreational Safety: Older Adult Falls: Get the Facts","year":"2014","unstructured":"Centers for Disease and Control Prevention: Home and Recreational Safety: Older Adult Falls: Get the Facts, Centers for Disease and Control Prevention, Atlanta, 2014."},{"key":"B4","series-title":"Foot Ankle Surg","first-page":"103","article-title":"Complications after open reduction and internal fixation of ankle fractures in the elderly","volume":"18","author":"Lynde MJ","year":"2012","unstructured":"Lynde MJ, Sautter T, Hamilton GA, et al: Complications after open reduction and internal fixation of ankle fractures in the elderly. Foot Ankle Surg 18: 103, 2012."},{"key":"B5","series-title":"Injury","first-page":"994","article-title":"Functional outcome following tibio-talar-calcaneal nailing for unstable osteoporotic ankle fractures","volume":"44","author":"Jonas SC","year":"2013","unstructured":"Jonas SC, Young AF, Curwen CH, et al: Functional outcome following tibio-talar-calcaneal nailing for unstable osteoporotic ankle fractures. Injury 44: 994, 2013."},{"key":"B6","series-title":"Curr Rev Musculoskelet Med","first-page":"439","article-title":"Retrograde hindfoot nailing for acute trauma","volume":"11","author":"Tarkin IS","year":"2018","unstructured":"Tarkin IS, Fourman MS: Retrograde hindfoot nailing for acute trauma. Curr Rev Musculoskelet Med 11: 439, 2018."},{"key":"B7","series-title":"Bone Joint J","first-page":"817","article-title":"Fragility fractures of the ankle in the frail elderly patient: treatment with a long calcaneotalotibial nail","volume":"96-B","author":"Al-Nammari SS","year":"2014","unstructured":"Al-Nammari SS, Dawson-Bowling S, Amin A, et al: Fragility fractures of the ankle in the frail elderly patient: treatment with a long calcaneotalotibial nail. Bone Joint J 96-B: 817, 2014."},{"key":"B8","series-title":"J Bone Joint Surg Br","first-page":"809","article-title":"Fragility fractures of the ankle: stabilization with an expandable calcaneotalotibial nail","volume":"87","author":"Lemon M","year":"2005","unstructured":"Lemon M, Somayaji HS, Khaleel A, et al: Fragility fractures of the ankle: stabilization with an expandable calcaneotalotibial nail. J Bone Joint Surg Br 87: 809, 2005."},{"key":"B9","series-title":"Foot Ankle Int","first-page":"41","article-title":"Relationship of prolonged operative time and comorbidities with complications after geriatric ankle fractures","volume":"38","author":"Aigner R","year":"2017","unstructured":"Aigner R, Salomia C, Lechler P, et al: Relationship of prolonged operative time and comorbidities with complications after geriatric ankle fractures. Foot Ankle Int 38: 41, 2017."},{"key":"B10","series-title":"Arch Orthop Trauma Surg","first-page":"423","article-title":"Fixation of ankle fragility fractures by tibiotalocalcaneal nail","volume":"128","author":"Amirfeyz R","year":"2008","unstructured":"Amirfeyz R, Bacon A, Ling J, et al: Fixation of ankle fragility fractures by tibiotalocalcaneal nail. Arch Orthop Trauma Surg 128: 423, 2008."},{"key":"B11","series-title":"Curr Rev Musculoskelet Med","first-page":"439","article-title":"Retrograde hindfoot nailing for acute ankle trauma","volume":"11","author":"Tarkin IS","year":"2018","unstructured":"Tarkin IS, Fourman MS: Retrograde hindfoot nailing for acute ankle trauma. Curr Rev Musculoskelet Med 11: 439, 2018."},{"key":"B12","series-title":"Injury","first-page":"519","article-title":"Fragility fractures of the ankle in the elderly: open reduction and internal fixation versus tibiotalocalcaneal nailing: short-term results of a prospective randomized controlled study","volume":"48","author":"Georgiannos D","year":"2017","unstructured":"Georgiannos D, Lampridis V, Bisbinas I: Fragility fractures of the ankle in the elderly: open reduction and internal fixation versus tibiotalocalcaneal nailing: short-term results of a prospective randomized controlled study. Injury 48: 519, 2017."},{"key":"B13","series-title":"Iowa Orthop J","first-page":"75","article-title":"Primary retrograde tibiotalocalcaneal nailing for fragility ankle fractures","volume":"36","author":"Taylor B","year":"2016","unstructured":"Taylor B, Hanse D, Harrison R, et al: Primary retrograde tibiotalocalcaneal nailing for fragility ankle fractures. Iowa Orthop J 36: 75, 2016."}],"container-title":["Journal of the American Podiatric Medical Association"],"original-title":[],"link":[{"URL":"https:\/\/japmaonline.org\/view\/journals\/apms\/115\/1\/22-099.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/japmaonline.org\/downloadpdf\/journals\/apms\/115\/1\/22-099.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/japmaonline.org\/downloadpdf\/journals\/apms\/115\/1\/22-099.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T10:19:56Z","timestamp":1783505996000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1930-8264\/115\/1\/22099"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,1]]},"references-count":13,"journal-issue":{"issue":"1"},"URL":"https:\/\/doi.org\/10.7547\/22-099","relation":{},"ISSN":["8750-7315"],"issn-type":[{"value":"8750-7315","type":"print"}],"subject":[],"published":{"date-parts":[[2025,1]]}}}