Conservative versus operative treatment for displaced ankle fractures in patients over 55 years of age: A prospective, randomised study

• Published in: Journal of bone and joint surgery. British volume Vol. 83; no. 4; pp. 525 - 529
• Main Authors: MAKWANA, N. K, BHOWAL, B, HARPER, W. M, HUI, A. W
• Format: Journal Article
• Language: English
• Published: London British Editorial Society of Bone and Joint Surgery 01-05-2001; British Editorial Society of Bone & Joint Surgery
• Edition: British volume
• Subjects: Age Factors; Aged; Aged, 80 and over; Ankle Injuries - therapy; Biological and medical sciences; Casts, Surgical; Female; Fracture Fixation, Internal; Fractures, Bone - therapy; Humans; Injuries of the limb. Injuries of the spine; Male; Medical sciences; Middle Aged; Prospective Studies; Range of Motion, Articular; Traumas. Diseases due to physical agents; Human; Prognosis; Indication; Orthopedic treatment; Diseases of the osteoarticular system; Lower limb; Fracture; Trauma; Displacement; Ankle; Orthopedic surgery; Treatment; Follow up study; Bone; Technique; Comparative study
• ISSN: 0301-620X; 2049-4394; 2044-5377; 2049-4408
• DOI: 10.1302/0301-620X.83B4.11522

Forty-seven patients over the age of 55 years with a displaced fracture of the ankle were entered into a prospective, randomised study in order to compare open reduction and internal fixation with closed treatment in a plaster cast; 36 were reviewed after a mean of 27 months. The outcome was assessed clinically, radiologically and functionally using the Olerud score. The results showed that anatomical reduction was significantly less reliable (p = 0.03) and loss of reduction significantly more common (p = 0.001) in the group with closed treatment. Those managed by open reduction and internal fixation had a significantly higher functional outcome score (p = 0.03) and a significantly better range of movement of the ankle (p = 0.044) at review.