Aigner René, Salomia Constantin, Lechler Philipp, Pahl Roman, Frink Michael
1 Center for Orthopaedics and Trauma Surgery, University Hospital of Giessen and Marburg, Marburg, Germany.
2 Institute for Medical Biometry and Epidemiology, Philipp University of Marburg, Marburg, Germany.
Foot Ankle Int. 2017 Jan;38(1):41-48. doi: 10.1177/1071100716667315. Epub 2016 Oct 1.
The incidence of geriatric ankle fractures has increased during the last few decades. In contrast to younger patients, increased complication rates have been observed. Thus, the goal of the present study was to identify risk factors for perioperative complications following open reduction and internal fixation of geriatric ankle fractures.
Two hundred thirty-seven patients over the age of 65 years (mean, 72.5 ± 6.1 years) treated for ankle fractures in our institution between 2004 and 2014 were included. Complications associated with operative treatment as well as complications requiring revision surgery were analyzed. In a multivariate analysis, risk factors were determined.
In 68 patients (28.7%), 74 complications were documented. The most common complications were impaired wound healing and operative site infections. The multivariate analysis revealed that the operative time was the only independent risk factor for the development of a complication. The operative time as well as the presence of an open fracture represented risk factors for needing revision surgery. Comorbidities did not influence the development of complications.
The operative management of geriatric ankle fractures was associated with a high complication rate. In the present study, the operative time was the only modifiable factor for the development of a complication that required revision surgery. During preoperative preparation, we believe that perfusion of the affected limb should be optimized to reduce the incidence of wound complications.
Level III, retrospective cohort study.
在过去几十年中，老年踝关节骨折的发病率有所上升。与年轻患者相比，观察到并发症发生率有所增加。因此，本研究的目的是确定老年踝关节骨折切开复位内固定术后围手术期并发症的危险因素。
纳入2004年至2014年间在本机构接受治疗的237例65岁以上（平均72.5±6.1岁）的踝关节骨折患者。分析与手术治疗相关的并发症以及需要翻修手术的并发症。在多变量分析中，确定危险因素。
68例患者（28.7%）记录了74例并发症。最常见的并发症是伤口愈合不良和手术部位感染。多变量分析显示，手术时间是发生并发症的唯一独立危险因素。手术时间以及开放性骨折的存在是需要翻修手术的危险因素。合并症不影响并发症的发生。
老年踝关节骨折的手术治疗并发症发生率较高。在本研究中，手术时间是发生需要翻修手术的并发症的唯一可改变因素。在术前准备期间，我们认为应优化患肢灌注以降低伤口并发症的发生率。
III级，回顾性队列研究。
