A Review of the Outcome of Geriatric Ankle Open Fracture Management at a Single Institution

Category: Trauma; Ankle Introduction/Purpose: There is an increasing trend of geriatric ankle fractures worldwide. The mortality rate of geriatric open ankle fractures is comparable to that of geriatric hip fractures. We aim to review the management and outcome of geriatric open ankle fractures at a single institution. Methods: Retrospective review of medical records of all patients above 60 years of age who had surgery foropen ankle or distal tibia and fibula fracutres between years 2017-2021 was performed. Demographic data, ambulatory status, ASA grade, comorbidities, surgical management, length of stay, outcome and radiographic data were recorded into a data collection form. A descriptive analysis of their outcome was performed. Results: 12 of 99 patients had open ankle fractures. Mean age cohort was 69.5 years (61- 85 years). 7 were female (58%). 67% (n=8) had low energy falls. 83% were independent community ambulators (n=10). 33% had diabetes, 17% had peripheral vascular disease and 25% had renal disease. Average follow up was 8.6 months (2 weeks- 32 months). 42% were Gustillo- Anderson grade 1 injuries, 33% Grade 2, 8% and 25% Grade 3 injuries. Mean length of stay patients was 13.5 days compared to 10.8 days for closed fractures.Patients spent a mean 52.6 days (28-77days) at the step down facility. 1 year mortality rate was 8% . Malunion and post traumatic arthritis rate was 11% each. There were no cases of deep surgical site infection or amputation. Conclusion: Open geriatric ankle fractures account for 12% of geriatric ankle fractures at our institution. They required longer length of stay and spent a mean 52.6 days at a stepdown facilty. Mortality rate was 8%. 50% of patients were able to return to previous ambulatory status. If the trend for geriatric ankle fractures continue to rise, health care systems need to cater for eventual increase in need for longer hospital stay and step down care.