Ankle fractures in the elderly: Do we have new concepts?

Raschke, Michael J.; Ochman, Sabine; Milstrey, Alexander

doi:10.1530/eor-23-0052

Cited by 3 publications

(1 citation statement)

References 61 publications

(73 reference statements)

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“…Additionally, the healing process after injury in the elderly typically takes longer, and the risk of complications is higher. [6][7][8] Therefore, the necessity of adopting age-specific approaches in the diagnosis and treatment of ankle injuries in elderly patients becomes evident.…”

Section: Introductionmentioning

confidence: 99%

The role of Ottawa ankle rules in geriatric emergency department visits

Seyhan

2024

Ulus Travma Acil Cerrahi Derg

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BACKGROUND: Ankle injuries are a common reason for visits to the emergency department (ED). An effective diagnosis and treatment process is crucial for the swift recovery of patients and for alleviating congestion in EDs. This study aims to evaluate the adequacy and effectiveness of the Ottawa Ankle Rules (OAR) in geriatric patients presenting to the emergency department (ED). METHODS:Between February 2022 and November 2022, 160 patients aged 65 and older (118 women, 42 men) who presented to the ED with isolated ankle injuries were included in the study. We calculated the sensitivity, specificity, positive predictive value, and negative predictive value of the OAR. RESULTS:The study found fractures in 37.5% of patients. The sensitivity of the OAR was 98.33%, the specificity was 86%, the negative predictive value was 98.85%, and the positive predictive value was 80.82%. CONCLUSION:This study demonstrates that the OAR is highly sensitive in the geriatric population but shows some limitations in terms of specificity and positive predictive value. These results support the effectiveness of using the OAR in evaluating ankle injuries in the geriatric population but also highlight the need for cautious application due to the potential for false-positive outcomes.

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Section: Introductionmentioning

confidence: 99%

The role of Ottawa ankle rules in geriatric emergency department visits

Seyhan

2024

Ulus Travma Acil Cerrahi Derg

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Tibiotalocalcaneal nail and primary closure for the management of open ankle fractures in the elderly patient; results from a major trauma centre

Cay,

Saad,

Bellringer

et al. 2024

Foot and Ankle Surgery

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Evaluating Fibular Intramedullary Nails vs Traditional Plating in Geriatric Ankle Fractures: A 12-Year Single-Center Retrospective Study

Lin,

Gao,

Zheng

et al. 2024

Foot Ankle Int.

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Background: This study evaluates the outcomes of fibular intramedullary nails (IMNs) compared to traditional plates and screws (PS) in the surgical treatment of unstable ankle injuries in patients aged ≥65 years. Method: We conducted a retrospective study involving 32 elderly patients with unstable ankle fractures treated with IMNs from 2010 to 2022. A comparison was made with 125 case-control patients treated with PS during the same period. Outcomes compared included postoperative wound and nonwound complications, surgical reduction, union rates, implant removal rates, and the Olerud Molander Ankle Score (OMAS) at a minimum follow-up of 2 years. Results: The IMN group had a higher incidence of high-energy injuries, open fractures, concomitant surgery, and perioperative transfusion requirements than the PS group. Additionally, the IMN group developed fewer wound-related (3.1% vs 20% in the PS group, P = .043) and non–wound-related complications (18.8% vs 39.2% in the PS group, P = .030). Both groups had similar initial weightbearing restrictions, fracture union times, mean OMAS scores, rates of malunion or nonunion, and delayed implant removal times. Notably, there were significant differences in the quality and adequacy of mortise alignment between the groups (good: 53.1% in IMN group vs 79.2% in PS group, fair: 46.9% in IMN group vs 20.8% in PS group, P = .006). Conclusion: Although the IMN group had an inferior outcome in the quality and adequacy of mortise reduction compared with the PS group, elderly patients with ankle fractures treated with IMN showed comparable functional outcomes to those treated with PS but with lower complication rates. Future research in this area will provide vital information for developing optimal treatment strategies, thereby improving the overall care of elderly patients with ankle fractures. Level of Evidence: Level III, case-control study.

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Ankle fractures in the elderly: Do we have new concepts?

Cited by 3 publications

References 61 publications

The role of Ottawa ankle rules in geriatric emergency department visits

The role of Ottawa ankle rules in geriatric emergency department visits

Tibiotalocalcaneal nail and primary closure for the management of open ankle fractures in the elderly patient; results from a major trauma centre

Evaluating Fibular Intramedullary Nails vs Traditional Plating in Geriatric Ankle Fractures: A 12-Year Single-Center Retrospective Study

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