Relationship of Prolonged Operative Time and Comorbidities With Complications After Geriatric Ankle Fractures.
BACKGROUND
The incidence of geriatric ankle fractures has increased during the last few decades. In contrast to younger patients, increased complication rates have been observed. Thus, the goal of the present study was to identify risk factors for perioperative complications following open reduction and internal fixation of geriatric ankle fractures.


METHODS
Two hundred thirty-seven patients over the age of 65 years (mean, 72.5 ± 6.1 years) treated for ankle fractures in our institution between 2004 and 2014 were included. Complications associated with operative treatment as well as complications requiring revision surgery were analyzed. In a multivariate analysis, risk factors were determined.


RESULTS
In 68 patients (28.7%), 74 complications were documented. The most common complications were impaired wound healing and operative site infections. The multivariate analysis revealed that the operative time was the only independent risk factor for the development of a complication. The operative time as well as the presence of an open fracture represented risk factors for needing revision surgery. Comorbidities did not influence the development of complications.


CONCLUSIONS
The operative management of geriatric ankle fractures was associated with a high complication rate. In the present study, the operative time was the only modifiable factor for the development of a complication that required revision surgery. During preoperative preparation, we believe that perfusion of the affected limb should be optimized to reduce the incidence of wound complications.


METHODS
Level III, retrospective cohort study.
1 Center for Orthopaedics and Trauma Surgery, University Hospital of Giessen and Marburg, Marburg, Germany.
René
R
Aigner
1 Center for Orthopaedics and Trauma Surgery, University Hospital of Giessen and Marburg, Marburg, Germany.
Constantin
C
Salomia
1 Center for Orthopaedics and Trauma Surgery, University Hospital of Giessen and Marburg, Marburg, Germany.
Philipp
P
Lechler
2 Institute for Medical Biometry and Epidemiology, Philipp University of Marburg, Marburg, Germany.
Roman
R
Pahl
1 Center for Orthopaedics and Trauma Surgery, University Hospital of Giessen and Marburg, Marburg, Germany.
Michael
M
Frink
D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D064386:Ankle Fractures / Q000150:complications* / Q000000981:diagnostic imaging / Q000601:surgery; D015897:Comorbidity; D048909:Diabetes Complications; D005260:Female; D005597:Fractures, Open; D006801:Humans; D008297:Male; D015999:Multivariate Analysis; D061646:Operative Time; D058729:Peripheral Arterial Disease / Q000150:complications; D011183:Postoperative Complications / Q000453:epidemiology*; D012086:Reoperation; D012189:Retrospective Studies; D012307:Risk Factors; D013530:Surgical Wound Infection / Q000453:epidemiology; D014945:Wound Healing
ankle fracture; complication; geriatric; operative time