Hindfoot Ankle Reconstruction Nail Trial (HARnT): Population Analysis of Surgical Treatment of Complex Ankle Fractures in the United Kingdom

Description

The presentation led by Tom Stringfellow, an orthopaedic registrar and member of the HARnT Research Cooperative Committee, delves into a multicenter analysis of surgical treatments for complex ankle fractures. Acknowledging contributions from BOTA members and collaborators nationwide, the talk seeks to uncover trends in patient characteristics and surgical outcomes related to hindfoot nailing.



The research outlines the necessary criteria for defining complex ankle fractures and specifies the focus on fractures suitable for intramedullary nailing. It addresses disparities in surgical techniques while emphasizing the significance of data collection across various units in the UK, involving 1,360 complex fractures recorded within six months of 2019.



Notable findings indicate that most fractures were managed with primary fixation, and a subset was treated using hindfoot nailing. Complications associated with these techniques were explored, revealing that hindfoot nailing presented a higher rate of complications compared to open reduction and internal fixation (ORIF), despite a noted lack of comprehensive functional scoring during data collection.



The study concludes that while hindfoot nails are often perceived as less prone to complications, evidence suggests otherwise. Recommendations call for further investigative efforts to clarify optimal management strategies for complex ankle fractures, highlighting the necessity for prospective studies and randomized trials to establish sound clinical practices.

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