Operative Management for Ankle Fractures Associated With High Complication Rate in Older Adults

Researchers recently found that the operative management of geriatric ankle fractures was associated with a high complication rate (Foot Ankle Int. published online ahead of print September 23, 2016; doi:10.1177/1071100716667315).

In contrast to younger patients, incidences of complications associated with geriatric ankle fractures have increased during the past few decades. Researchers Michael Frink, MD, University Hospital of Giessen and Marburg (Germany) and colleagues sought to identify risk factors for perioperative complications following open reduction and internal fixation of geriatric ankle fractures.

Two hundred thirty-seven patients older than 65 (mean, 72.5 ± 6.1 years) treated for ankle fractures at the researchers’ institution between 2004 and 2014 were included. Complications associated with operative treatment, as well as complications requiring revision surgery, were analyzed.

Overall, in 68 patients (28.7%), 74 complications were documented, with wound healing and operative site infections proving to be the most common. A multivariate analysis revealed that the operative time was the only independent risk factor for the development of a complication. They determined that operative time, as well as the presence of an open fracture, represented risk factors for needing revision surgery. Comorbidities were not found to influence the development of complications.

Dr Frink and colleagues concluded that a high complication rate was related to operative management; they suggest that, during preoperative preparation, the perfusion of the affected limb should be optimized so as to reduce the incidence of wound complications.—Amanda Del Signore