Ankle Fractures in the Elderly: Initial and Long-term Outcomes
Ankle Fractures in the Elderly: Initial and Long-term Outcomes
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DOI：
10.3113/fai.2008.1184
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发表时间：
2008-12-01
影响因子：
2.7
通讯作者：
Wixted, John J.
中科院分区：
文献类型：
--
作者：
Anderson, Sarah A.;Li, Xinning;Wixted, John J.
背景：踝关节骨折的手术治疗将成为老年人骨科实践中越来越重要的一部分。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结果。本研究的目的是评估老年和非老年人群孤立性踝关节骨折手术治疗后的短期和长期结局。材料与方法：回顾了25例65岁以上患者和46例65岁以下患者的病历和X线片，这些患者在2年内接受了踝关节骨折手术治疗。观察到术后并发症和出院后需要安置在专业护理机构。完成SF-36和Olerud和Molander踝关节评分。65岁以上患者的平均随访时间为27个月，65岁以下患者的平均随访时间为24个月。结果如下：65岁以上的患者术后并发症发生率较高（40%vs.11%，p < 0.007），需要入住疗养院的频率高于65岁以下的患者（p < 0.0001）。在长期随访中，数据显示患者报告的身体结局无显著差异。结论：踝关节骨折手术固定后的早期术后结局表明，65岁以上患者的结局明显较差。然而，在该样本中，老年人的长期功能与65岁以下的患者相当。老年人的心理综合评分明显好于非老年人。
Background: 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. Materials and Methods: 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. Results: 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. Conclusion: 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.