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Ankle fractures in the elderly: risks and management challenges

Authors Kadakia RJ, Ahearn BM, Schwartz AM, Tenenbaum S, Bariteau JT

Received 20 December 2016

Accepted for publication 29 March 2017

Published 29 May 2017 Volume 2017:9 Pages 45—50


Checked for plagiarism Yes

Review by Single-blind

Peer reviewer comments 3

Editor who approved publication: Professor Clark Hung

Rishin J Kadakia,1 Briggs M Ahearn,1 Andrew M Schwartz,1 Shay Tenenbaum,2 Jason T Bariteau1

1Department of Orthopaedics, Emory University School of Medicine, Atlanta, GA, USA; 2Department of Orthopedic Surgery, Chaim Sheba Medical Center at Tel Hashomer, Affiliated to the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel

Abstract: Ankle fractures are the third most common osseous injury in the elderly, behind hip and distal radius fractures. While there is a rich history of clinical advancement in the timing, technique, perioperative management, and associated risks of hip fractures, similar evaluations are only more recently being undertaken for ankle fractures. Traditionally, elderly patients were treated more conservatively; however, nonoperative management has been found to be associated with increased mortality. As such, older and less healthy patients have become operative candidates. The benefits of geriatric/orthopedic inpatient comanagement that have been well elucidated in the hip fracture literature also seem to improve outcomes in elderly patients with ankle fractures. One of the orthopedist’s roles is to recognize the complexities of osteoporotic bone fixation and optimize wound healing potential. Though the immediate cost of this surgical approach is inevitably higher, the ultimate cost of long-term care has been found to be substantially reduced. It is important to consider the mortality and morbidity benefits and cost reductions of operative intervention and proper inpatient care of geriatric ankle fractures when they present to the emergency department or the office.

Keywords: ankle fractures, geriatrics, trauma, outcomes, management, surgery

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