Ankle fractures in the elderly: initial and long-term outcomes

Area of Science:

• Orthopaedic surgery
• Geriatric medicine
• Trauma care

Background:

• Ankle fractures are common in aging adults, increasing the need for surgical management.
• Limited research compares surgical outcomes in elderly versus younger patients with ankle fractures.
• This study addresses the gap by evaluating outcomes in different age groups.

Purpose of the Study:

• To compare short- and long-term outcomes of surgical treatment for isolated malleolar ankle fractures.
• To assess outcomes in patients over 65 years compared to those under 65.
• To identify differences in complications, functional scores, and mental health.

Main Methods:

• Retrospective review of 25 patients over 65 and 46 patients under 65 undergoing ankle fracture surgery.
• Data collected included postoperative complications and need for skilled nursing facility placement.
• Functional outcomes assessed using SF-36 and Olerud and Molander Ankle Score at mean follow-up of 27 months (elderly) and 24 months (younger).

Main Results:

• Patients over 65 had significantly more postoperative complications (40% vs. 11%, p < 0.007).
• Elderly patients required nursing home placement more frequently (p < 0.0001).
• No significant difference in long-term patient-reported physical outcomes was observed between age groups.

Conclusions:

• Surgical fixation of ankle fractures leads to worse early outcomes in patients over 65.
• Long-term functional recovery in the elderly is comparable to younger patients.
• The elderly group demonstrated a significantly better mental composite score.