Abstract
Introduction: Controversy exists in the surgical treatment of unstable ankle fractures in the very elderly age group of over 80 years. Operative fixation in these cases is challenging and the postoperative mortality and morbidity has discouraged surgical intervention in this population. However, the literature regarding the prognosis of surgery in this elderly group is very limited. The purpose of our study was to describe the results of 92 patients aged above 80 years, who underwent operative fixation for unstable ankle fractures.
Methods: 92 consecutive patients aged above eighty years of age had open reduction and internal fixation for unstable ankle fractures during the period of January 1998 – August 2007. The data was collected retrospectively from the case records and radiographs. A standard postoperative rehabilitation programme was followed. The complications were noted and the risk factors for poor prognosis were analysed.
Results: There were 80 women and 12 men in the study. The average age was 85.2 (Range 80.1 – 95.1 yrs). The minimum duration of follow up was 9 months. The superficial wound infection rate was 7% (6 cases) and the deep infection rate was 4.6% (4 cases). The 30 day postoperative mortality was 5.4 % (5 cases). 86 % (75 out of 87 cases) were able to return back to their pre injury mobility at the last follow-up. Diabetes, dementia, peripheral vascular disease and smoking were found to be statistically significant risk factors associated with wound complications. Patient with 2 or more risk factors is 5 times more likely to have wound infection.
Conclusion: The results of operative fixation of unstable ankle fractures are very encouraging with majority of patients returning to pre injury mobility status.
The abstracts were prepared by Mr Matt Costa and Mr Ben Ollivere. Correspondence should be addressed to Mr Costa at Clinical Sciences Research Institute, University of Warwick, Clifford Bridge Road, Coventry CV2 2DX, UK.
