Audit of ankle fracture fixation in the elderly

To assess the results of operative treatment of ankle fractures in the elderly, we have reviewed the results of ankle fracture fixation in 76 patients aged over 50 years. This was carried out with special reference to the early complications. Our series had a 1.8% incidence of infection and a 5.2% incidence of delayed healing and wound necrosis. Malunion occurred in 7.9% of patients, and was due in all cases to either imperfect peroperative reduction or inadequate fixation. In no case did fixation fail because of poor bone quality. We conclude that internal fixation of ankle fractures in the elderly carries acceptable risks, so long as careful attention is paid to surgical technique, and fixation is in accordance with AO/ASIF principles.