Complications After Surgical Treatment of Geriatric Ankle Fractures |
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Authors: | Reinier W.A. Spek Diederik P.J. Smeeing Linda van den Heuvel Marike C. Kokke Abhiram R. Bhashyam Johannes C. Kelder Egbert J.M.M. Verleisdonk Roderick M. Houwert Detlef van der Velde |
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Affiliation: | 1. Medical Student, Department of Trauma, University Medical Center Utrecht, Utrecht, The Netherlands;2. Surgical Resident, Department of Surgery, Slingeland Hospital, Doetinchem, The Netherlands;3. Physician Assistant, Department of Surgery, St Antonius Hospital, Utrecht, The Netherlands;4. Trauma Surgeon, Department of Surgery, St Antonius Hospital, Utrecht, The Netherlands;5. Resident, Harvard Combined Orthopaedic Surgery Residency Program, Boston, MA;6. Medical Doctor, Department of Cardiology, St Antonius Hospital, Nieuwegein, The Netherlands;7. Trauma Surgeon, Department of Surgery, Diakonessenhuis Hospital, Utrecht, The Netherlands;8. Trauma Surgeon, Department of Surgery, University Medical Center Utrecht, Utrecht, The Netherlands;9. Trauma Surgeon, Utrecht Trauma Center, Utrecht, The Netherlands;10. Trauma Surgeon, Department of Surgery, St Antonius Hospital, Utrecht, The Netherlands |
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Abstract: | The incidence of geriatric ankle fractures is rising and the potential for complications is high in this population. Little is known about factors associated with increased postoperative complications after surgical fixation of ankle fractures in older-age patients. The purpose of this retrospective cohort study was to assess the epidemiology and risk factors for complications after surgically treated ankle fractures in geriatric patients. All patients who were 65 years or older and had a surgically treated ankle fracture were included. Pilon fractures, patients who were initially treated conservatively or who had less than 1 month of follow-up were excluded. Postoperative complications, demographic-, fracture- and surgical data of 282 patients were recorded from two level 2 trauma centers between 2012 and 2017. A total of 87 (30.9%) patients developed a complication, of which wound related complications were most frequently reported. Superficial and deep wound infections were observed in 27 (9.6%) and 18 (6.4%) patients, respectively. Multivariate regression analysis demonstrated increased age to be an independent predictive variable for the occurrence of postoperative complications (odds ratio 1.04; 95% confidence interval 1.00-1.09), while cast immobilization for more than 2 weeks was a protective factor for the development of wound related complications (odds ratio 0.34; 95% confidence interval 0.17-0.66). In conclusion, the incidence of postoperative complications among geriatric patients after surgical treatment of ankle fractures is high and patients should be informed accordingly. |
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