Abstract
Introduction
Orthogeriatric ankle fractures seem to play an essential role in terms of quality
of life in the elderly. Knowledge of the outcome after orthogeriatric ankle fractures
is sparse. The present study investigates the outcome after surgically treated ankle
fractures at a certified orthogeriatric trauma center.
Material & Methods
A retrospective observational study was performed investigating the outcome of surgically
treated ankle fractures in orthogeriatric patients between 2015-2017. Outcome parameters
included but were not limited to the EQ-5D 3 L, Barthel Index, Karlsson Score and
the Charlson Comorbidity Index. Housing situation and mobility were evaluated and
potential associations to the fracture pattern and the related treatment strategy
were investigated.
Results
In total, 58 patients were included (age 77.7 ± 6,2 years). The majority were AO-44
B2 fractures (72%). General outcome was related to the Parker score; a Parker Score
of 9 prior surgery was independently associated with an improved outcome according
to the EQ-5D 3 L and Barthel Index. Patients under 80 years of age also had better
results.
Place of residence did not significantly change after surgery. Neither different types
of implants nor initial use of an external fixator (e.g. open fractures) did influence
outcome. A wound healing impairment was found in 10% of our patients whereas the overall
unplanned reoperation rate was 7%. Overall complication rate was 20%, one-year mortality
was 10%.
Conclusions
Surgically treated ankle fractures in the elderly which are treated in a certified
geriatric fracture center seem to have limited negative effect on their quality of
life. We did not observe the otherwise often demonstrated high mortality rates, but
still nearly half of the patients demonstrated perioperative complications, which
emphasizes the need for optimal perioperative care at an orthogeriatric trauma center.
Since there was a reasonable number of patients with wound healing issues this study
supports the idea of a staged protocol using external fixation with secondary ORIF.
Keywords
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Article info
Publication history
Published online: July 02, 2018
Accepted:
June 21,
2018
Received:
May 2,
2018
Identification
Copyright
© 2018 Elsevier Ltd. All rights reserved.
