OTA 2006 Posters

Scientific Poster #100 Geriatrics

Functional Outcome after Surgically Treated Ankle Fractures in the Elderly
Roy I. Davidovitch, MD (n); Toni M. McLaurin, MD (n);
Nirmal C. Tejwani, MD (e-EBI, Zimmer); Michael Walsh, PhD (n);
Kenneth J. Koval, MD (e-Stryker, EBI); Kenneth A. Egol, MD (n);
NYU­Hospital for Joint Diseases, New York, New York, USA

Introduction: This study is a comparison of functional outcome following surgical stabilization of ankle fractures in an elderly (60 years old) and nonelderly population (<60).

Methods: From October 2000 to December 2004, 369 patients (313 <60 years, 56 60) surgically treated for unstable ankle fractures were entered into a database and followed at 3, 6, and 12-month intervals. Postoperative protocol consisted of non-weight bearing and functional bracing for 6 weeks with passive/active ankle motion. Baseline characteristics, complications, additional surgery, functional status, and the American Orthopaedic Foot and Ankle Society (AOFAS) score were assessed. Data were analyzed by contingency table methods or Student t test. Covariants were age, sex, tobacco use, diabetes, American Society of Anesthesiologists (ASA) classification, length of stay (LOS), and fracture type. P <0.05 was significant.

Results: 313 patients were <60 years old and 56 were 60 years old. Complete follow-up was available for 74% of patients. OTA codes included: 44A (7.6%), 44B (73.4%), and 44C (19%). There were no significant differences in fracture type, pain, tobacco use, or LOS (P >0.05). The 60-year-old group was more likely women, diabetics, and had higher ASA scores (P <0.001). At 3 months, 57% of patients 60 years old reported limited activities versus 33% of <60-year-olds (P = 0.005). At 6 months, 41% of 60-year-olds versus 10% of <60-year-olds reported limited activities (P = 0.001) and at 12 months, the difference was 29% of 60-year-olds and 7.4% of <60-year-olds (P = 0.001). Total AOFAS scores were not significantly different at 3,6, and 12 months (P>0.431).

Conclusion/Significance: This is the first study comparing functional outcomes of elderly and nonelderly patients following operative fixation of ankle fractures. Results show that functional outcomes steadily improve over the 1-year follow-up at a slower rate than in the younger cohort of patients. There is evidence here that operative fixation of unstable ankle fractures in the elderly can provide a reasonable functional result at the 1-year follow-up.

If noted, the author indicates something of value received. The codes are identified as a-research or institutional support; b-miscellaneous funding; c-royalties; d-stock options; e-consultant or employee; n-no conflicts disclosed, and *disclosure not available at time of printing.
· The FDA has not cleared this drug and/or medical device for the use described in this presentation (i.e., the drug or medical device is being discussed for an "off label" use). · · FDA information not available at time of printing.