Open Ankle Fractures in Older Individuals: A Multi-center Study

Area of Science:

• Orthopedic Surgery
• Trauma Surgery
• Geriatric Medicine

Background:

• Open ankle fractures present unique challenges in older populations.
• Understanding risk factors and outcomes is crucial for geriatric trauma care.

Purpose of the Study:

• To identify demographics, etiology, comorbidities, treatment, complications, and outcomes for older patients (≥60 years) with open ankle fractures.
• To determine independent predictors of postoperative amputation and 1-year mortality.

Main Methods:

• Retrospective review of 162 patients (≥60 years) with open ankle fractures from 6 Level 1 trauma centers (2004-2014).
• Univariate and multivariate logistic regression analyses were used to identify predictors of amputation and mortality.

Main Results:

• Ground-level falls were the most common injury mechanism (51.9%). Bimalleolar (52.5%) and trimalleolar (26.5%) fractures were most frequent.
• Complications included superficial infection (15.4%), deep infection (9.9%), and amputation (9.3%). 1-year mortality was 13.6%, overall mortality 25.9%.
• Male gender and fracture type predicted amputation. Older age and diabetes predicted 1-year mortality.

Conclusions:

• Open ankle fractures in older individuals are associated with significant rates of amputation and mortality.
• Early identification of risk factors is essential for improving patient management and outcomes.