Wirral University Hospitals NHS Trust, Arrowe Park Hospital, Arrowe Park Road, Upton, Wirral CH45 5PE, United Kingdom.
Foot Ankle Int. 2011 Jun;32(6):599-602. doi: 10.3113/FAI.2011.0599.
Controversy exists regarding the surgical treatment of unstable ankle fractures in the very elderly age group of over 80 years. However, the literature regarding the prognosis of surgery in this elderly group is limited. The purpose of our study was to evaluate the results of patients above 80 years old who underwent operative fixation for unstable ankle fractures.
Ninety-two consecutive patients, 80 females and 12 males, above 80 years of age had open reduction and internal fixation for unstable ankle fractures during the period of January 1998 to August 2007. The data was collected retrospectively from the case records and radiographs. The complications were noted and the risk factors for poor outcome were analyzed. The average age was 85.2 (range, 80.1 to 95.1) years. The minimum duration of followup was 9 months, with an average of 15 (range, 9 to 28) months.
The most common fracture pattern was Danis-Weber B type. The superficial wound infection rate was 7% (6 cases) and the deep infection rate was 4.6% (4 cases). The 30 day postoperative mortality was 5.4% (five cases). Eighty-six percent (75 out of 87 cases) were able to return back to their pre injury mobility at the last followup. Diabetes, dementia, peripheral vascular disease and smoking were found to be statistically significant risk factors associated with wound complications.
The results of operative fixation of unstable ankle fractures were encouraging with good functional recovery and return to pre injury mobility status in most cases.
对于 80 岁以上的超高龄人群，不稳定踝关节骨折的手术治疗存在争议。然而，关于该老年人群手术预后的文献有限。我们的研究目的是评估 80 岁以上行手术固定不稳定踝关节骨折患者的结果。
1998 年 1 月至 2007 年 8 月期间，92 例连续患者（80 名女性和 12 名男性）年龄均超过 80 岁，患有不稳定踝关节骨折，行切开复位内固定术。从病历和 X 线片中回顾性收集数据。记录并发症，并分析不良预后的危险因素。平均年龄为 85.2 岁（范围，80.1 岁至 95.1 岁）。最短随访时间为 9 个月，平均为 15 个月（范围，9 至 28 个月）。
最常见的骨折类型为 Danis-Weber B 型。浅表伤口感染率为 7%（6 例），深部感染率为 4.6%（4 例）。术后 30 天死亡率为 5.4%（5 例）。86%（87 例中的 75 例）在最后一次随访时能够恢复到受伤前的活动水平。糖尿病、痴呆、外周血管疾病和吸烟被发现与伤口并发症有统计学显著的相关危险因素。
不稳定踝关节骨折手术固定的结果令人鼓舞，大多数患者的功能恢复良好，可恢复到受伤前的活动水平。
