title: Conservative versus operative treatment for displaced ankle fractures in patients over 55 years of age. A prospective, randomised study.
abstract: 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.
authors.affiliation: Leicester Royal Infirmary, England.
authors.forename: N K
authors.initials: NK
authors.lastname: Makwana
authors.forename: B
authors.initials: B
authors.lastname: Bhowal
authors.forename: W M
authors.initials: WM
authors.lastname: Harper
authors.forename: A W
authors.initials: AW
authors.lastname: Hui
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D016512:Ankle Injuries / Q000628:therapy*; D002370:Casts, Surgical; D005260:Female; D005593:Fracture Fixation, Internal; D050723:Fractures, Bone / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D016059:Range of Motion, Articular