Ankle fractures of the geriatric patient: a narrative review

Abstract

The present narrative review provides a summary of current concepts for the treatment of ankle fractures in elderly patients. Despite a high complication rate, open reduction and internal fixation is the gold standard for operative care. However, individual patient-based treatment decision considering the soft-tissue status, the fracture pattern, as well as the patient's mobility and comorbidities is mandatory to achieve sufficient patient outcomes. Due to high complication rates after surgery in the past, techniques such as fibular nails or minimal invasive techniques should be considered.

Keywords: ankle fracture; fibular nail; fragility fracture; geriatric fracture; osteoporosis.

Figure 1

(A) Suprasyndesmotic fibula fracture after open reduction and internal fixation and stabilization with a positioning screw; (B) fibula fracture with a medial malleolar fracture and fracture of the posterolateral rim (Volkmann’s fragment) after closed reduction and stabilization with an external fixator and retrograde K-wires; (C) transsyndesmotic fibula fracture with a medial malleolar fracture after closed reduction of the distal fibula and stabilization with a retrograde fibular nail and open reduction of the medial fracture and stabilization with a compression screw and a K-wire.