手术治疗老年人踝关节骨折的疗效观察

目的比较老年人和非老年成人不稳定踝关节骨折手术治疗的临床疗效。方法对60岁以上的32例患者和60岁以下的96例患者进行了1年的术后随访，随访的内容主要包括术后并发症、出院后对生活护理的需求、SF-36以及AOFAS评分。平均随访时间是16．2个月。结果本组128例患者分别术后1、2、3、6、12个月获访。随访12～36个月，平均16．2个月。能完整随访到的是78例，老年组27例，非老年组51例。两组均未出现内固定物松动、滑脱。老年组患者术后初期需要生活护理15例（55．6％），非老年组2例（3．9％）老年组出现并发症11例（40．7％），非老年组4例（9．8％），两组比较差异有显著性（P〈0．05）。结论老年人踝关节骨折手术后早期与非老年人相比有较差的临床疗效，然而，远期的临床疗效，两组是相似的。这些研究结果对于老年人踝关节骨折手术策略的制定是非常有意义的。

Surgical treatment of ankle fractures in the elderly patients

Objective To compare the efficacy of surgical treatment for unstable ankle fractures in elderly and non-elderly patients. Methods 27 patients aged 60 or older and 51 younger than 60 were followed up one year postoperatively. Postoperative complications and the need for nursing support after discharge were noted. The scores for SF-36 and AO FAS were determined. Mean duration of follow-up was 16.2 months. Results More complications occurred and more nursing support was need in the elderly patients than in the non-elderly patients (P＜0.001). Long-term follow-up showed the efficacy was similar in the two groups (P＞ 0.05). Conclusopms Ederly patients have a worse short-term efficacy of surgical treatment for ankle fractnres than non-elderly patients; however, the long-term efficacy is similar in the two groups. The finding of this study is of significance in making surgical strategies in the treatment of ankle fractures in elderly patients.