René Aigner1, Constantin Salomia1, Philipp Lechler1, Roman Pahl2, Michael Frink1. 1. 1 Center for Orthopaedics and Trauma Surgery, University Hospital of Giessen and Marburg, Marburg, Germany. 2. 2 Institute for Medical Biometry and Epidemiology, Philipp University of Marburg, Marburg, Germany.
Abstract
BACKGROUND: 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. METHODS: 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. RESULTS: 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. CONCLUSION: 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 OF EVIDENCE: Level III, retrospective cohort study.
BACKGROUND: 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. METHODS: 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. RESULTS: 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. CONCLUSION: 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 OF EVIDENCE: Level III, retrospective cohort study.
Entities:
Keywords:
ankle fracture; complication; geriatric; operative time
Authors: René Aigner; Philipp Lechler; Christoph Kolja Boese; Benjamin Bockmann; Steffen Ruchholtz; Michael Frink Journal: Int Orthop Date: 2017-12-14 Impact factor: 3.075
Authors: Mitchell T Gray; Krystin A Hidden; Azeem T Malik; Safdar N Khan; Laura Phieffer; Thuan V Ly; Carmen E Quatman Journal: Geriatr Orthop Surg Rehabil Date: 2021-05-04