title: Are low-energy open ankle fractures in the elderly the new geriatric hip fracture?
abstract: As the geriatric population in the United States continues to increase, ankle fractures in the elderly are predicted to exponentially increase in the future. As such, these injuries will become a common injury seen by physicians in various fields. Currently, no studies discussing low-energy open ankle fractures in the elderly and/or the mortality rate associated with these devastating injuries have been published. The purpose of the present study was to retrospectively review the morality rate associated with low-energy open ankle fractures in the elderly. We retrospectively identified 11 patients >60 years old who had sustained low-energy open ankle fractures and been treated at our institution. The patient demographics, mechanism of injury, wound size, medical comorbidities, treatment, follow-up data, and outcomes were recorded. Low-energy falls were defined as ground level falls from sitting or standing. The mean age of the patients was 70.72 years, with a mean body mass index of 35.93 ± 10.24. Of the 11 patients, 9 (81.81%) had ≥3 comorbidities (i.e., hypertension, diabetes, coronary artery disease, congestive heart failure, and/or chronic obstructive pulmonary disease). The mean size of the medially based ankle wound was 14.18 ± 4.12 cm; 10 (90.90%) were Gustilo and Anderson grade IIIA open ankle fractures. In our study, low-energy open ankle fractures in the elderly, very similar to hip fractures, were associated with a high mortality incidence (27.27%) at a mean of 2.67 ± 2.02 months, and 81.81% of our patients had ≥3 medical comorbidities.
authors.affiliation: Department of Orthopaedic Surgery and Rehabilitation, University of Florida College of Medicine-Jacksonville, Jacksonville, FL. Electronic address: William.toole@jax.ufl.edu.
authors.forename: William P
authors.initials: WP
authors.lastname: Toole
authors.affiliation: Department of Orthopaedic Surgery and Rehabilitation, University of Florida College of Medicine-Jacksonville, Jacksonville, FL.
authors.forename: Mark
authors.initials: M
authors.lastname: Elliott
authors.affiliation: Department of Orthopaedic Surgery and Rehabilitation, University of Florida College of Medicine-Jacksonville, Jacksonville, FL.
authors.forename: David
authors.initials: D
authors.lastname: Hankins
authors.affiliation: Department of Orthopaedic Surgery and Rehabilitation, University of Florida College of Medicine-Jacksonville, Jacksonville, FL.
authors.forename: Corey
authors.initials: C
authors.lastname: Rosenbaum
authors.affiliation: Department of Orthopaedic Surgery and Rehabilitation, University of Florida College of Medicine-Jacksonville, Jacksonville, FL.
authors.forename: Anthony
authors.initials: A
authors.lastname: Harris
authors.affiliation: Department of Orthopaedic Surgery and Rehabilitation, University of Florida College of Medicine-Jacksonville, Jacksonville, FL.
authors.forename: Christopher
authors.initials: C
authors.lastname: Perkins
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D064386:Ankle Fractures / Q000150:complications* / Q000401:mortality* / Q000628:therapy; D015992:Body Mass Index; D005260:Female; D005597:Fractures, Open / Q000150:complications* / Q000401:mortality* / Q000628:therapy; D006304:Health Status; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D012189:Retrospective Studies; D012307:Risk Factors
keywords: geriatric; insufficiency fracture; morbidity and mortality; open fracture