Ankle fractures in the elderly: MUA versus ORIF

A series of 80 patients over the age of 60 years with ankle fractures were reviewed retrospectively. 'Pilon' and talar fractures were excluded; 41 were treated conservatively (MUA) and 39 by operation (ORIF). The mean follow-up was 28 months (range 18-38 months) in the ORIF group and 25.5 months (range 12-40 months) in the MUA group. A statistically significant proportion of patients were satisfied with regard to pain, swelling, stiffness, instability and ranges of movement after ORIF. Anatomical congruity of the ankle mortice was better maintained following ORIF. Poor subjective and objective end results correlated with malalignment of the ankle mortice on the final radiograph at follow-up.