Anderson Sarah A, Li Xinning, Franklin Patricia, Wixted John J
University of Massachusetts Medical Center, Department of Orthopaedic Surgery, Worcester, MA 01655, USA.
Foot Ankle Int. 2008 Dec;29(12):1184-8. doi: 10.3113/FAI.2008.1184.
Surgical management of ankle fractures will be an increasing part of the orthopaedic practice for aging adults. To date, there are few studies comparing outcomes after ankle fracture surgery between patients over and under 65 years. The purpose of this study was to evaluate short- and long-term outcomes after surgical treatment of isolated malleolar fractures in both the elderly and non-elderly population.
Charts and radiographs were reviewed for 25 patients over age 65 and 46 patients under age 65 who underwent operative treatment of an ankle fracture during a 2-year period. Postoperative complications and need for placement in a skilled nursing facility following discharge were noted. The SF-36 and the Olerud and Molander Ankle Score were completed. Mean duration of followup in patients greater than 65 was 27 months and 24 months for patients less than or equal to 65 years.
Patients over 65 had a higher number of postoperative complications (40% vs. 11%, p < 0.007), and required nursing home placement more frequently than patients under 65 (p < 0.0001). At long-term followup, the data showed no significant difference in patient reported physical outcomes.
Early postoperative outcomes after operative fixation of ankle fractures suggest significantly worse outcomes for patients over age 65. However, long-term function in the elderly was comparable to patients under age 65 in this sample. The elderly population had a significantly better mental composite score than the non-elderly.
踝关节骨折的手术治疗在老年骨科患者的治疗中所占比例将日益增加。迄今为止，很少有研究比较65岁以上和65岁以下患者踝关节骨折手术后的疗效。本研究的目的是评估老年和非老年人群单纯踝关节骨折手术治疗后的短期和长期疗效。
回顾了25例65岁以上和46例65岁以下患者的病历和X线片，这些患者在2年期间接受了踝关节骨折手术治疗。记录术后并发症及出院后入住专业护理机构的需求情况。完成了SF-36量表以及奥勒鲁德和莫兰德踝关节评分。65岁以上患者的平均随访时间为27个月，65岁及以下患者为24个月。
65岁以上患者术后并发症较多（40%对11%，p<0.007），且比65岁以下患者更频繁地需要入住养老院（p<0.0001）。在长期随访中，数据显示患者报告的身体状况没有显著差异。
踝关节骨折手术固定后的早期术后结果表明，65岁以上患者的结果明显较差。然而，在本样本中，老年人的长期功能与65岁以下患者相当。老年人群的精神综合评分明显高于非老年人群。
