Abstract
Introduction: Operative fixation of unstable ankle fractures is a well-recognised form of management. However controversy exists in the surgical treatment of unstable ankle fractures in the elderly age group, over 80 years. Operative fixation in these cases is challenging and the postoperative mortality and morbidity has discouraged surgical intervention. The literature regarding the prognosis of surgery in this elderly group is limited. The purpose of this study is to document the results of operative fixation of unstable ankle fractures in patients aged over 80 years of age.
Methods: Ninety-two consecutive patients aged above 80 underwent open reduction and internal fixation of unstable ankle fractures during the period of January 1998 to August 2007. Five patients’ case records were unavailable for the study and they were therefore excluded. The data was collected retrospectively from the case records and radiographs. The clinical and radiological outcomes following surgery were recorded and analysed in detail. The complications were noted and the risk factors for poor prognosis were analysed
Results: The average age was 85.2 (range 80.1 – 95.1 yrs). The minimum duration of follow up was nine months. The superficial wound infection rate was 5.7% (5 cases). The deep infection rate was 4.6% (4 cases), three required surgical debridement. The 30-day postoperative mortality was 4.6 % (4 cases). 88.1 % (74 out of 84 cases) were able to return to their preinjury mobility at the last follow-up. Diabetes and smoking did not statistically influence the outcome of the surgery.
Conclusion: The results of operative fixation of unstable ankle fractures in this age group are encouraging with good functional recovery and return to preinjury mobility status in most cases.
Correspondence should be addressed to A.H.N. Robinson, BOX 37, Department of Orthopaedics, Addenbrooke’s Hospital, Cambridge University Hospitals NHS Trust, Hills Road, Cambridge. CB2 0QQ, England.
