Functional outcome after operatively treated ankle fractures in the elderly

Area of Science:

• Orthopedic Surgery
• Trauma Surgery
• Geriatric Orthopedics

Background:

• Unstable ankle fractures require operative stabilization.
• Functional outcomes in older adults (≥60 years) versus younger patients (<60 years) after surgery are compared.
• Retrospective analysis of prospectively collected data from multiple trauma centers.

Purpose of the Study:

• To compare functional outcomes between younger and older patients undergoing operative stabilization of unstable ankle fractures.
• To assess the impact of age on recovery and functional status post-surgery.

Main Methods:

• Operative treatment included open reduction and internal fixation for unstable ankle fractures.
• Patients were prospectively followed, with data collected on baseline characteristics, complications, and functional status.
• Primary outcome measures: American Orthopaedic Foot and Ankle Society (AOFAS) hindfoot score and Short Musculoskeletal Functional Assessment (SMFA) questionnaire.

Main Results:

• At 3 months, 57% of patients ≥60 years reported activity limitations versus 33% of patients <60 years (p=0.005).
• By 12 months, activity limitations improved significantly in both groups, with older patients reporting 29% limitations vs. 7.4% in younger patients (p=0.001).
• Both age groups achieved a return to pre-injury functional status, with no significant difference in total AOFAS scores at 3, 6, or 12 months (p=0.431).

Conclusions:

• Operative fixation of unstable ankle fractures provides reasonable functional results for patients ≥60 years.
• Older patients may experience more initial activity limitations but achieve a return to preoperative baseline function by one year.
• Surgical stabilization is effective in restoring function regardless of age group.