Title : Surgical and functional outcomes in ankle Open Reduction Internal Fixation (ORIF) vs Protibial fixation in patients above 60 years old: Retrospective study
Abstract:
This retrospective study compares surgical and functional outcomes between ankle open reduction internal fixation (ORIF) and protibial fixation in elderly patients aged above 70 years. The objective was to evaluate postoperative complications , recovery, weight-bearing status, and their association with preoperative comorbidities quantified using the Charlson Comorbidity Index.
Data from 140 elderly patients (110 ORIF, 30 protibial fixation) were analyzed. The mean Charlson Comorbidity Index was slightly higher in the ORIF group (0.075) compared to the protibial group (0.0), indicating marginally increased comorbidity burdens among ORIF patients. Early weight-bearing (partial or full weight-bearing within 6 weeks post-operation) was achieved in 11 ORIF patients (10%) and 11 protibial patients (36.7%), highlighting significantly better early mobility outcomes associated with protibial fixation. Postoperative complications, including delayed wound healing, superficial infections, and revision surgeries, occurred more frequently in the ORIF group (18.2%) compared to the protibial fixation group (6.7%).
Our findings suggest that protibial fixation might offer superior early functional recovery and fewer postoperative complications in elderly patients, despite ORIF being a widely utilized technique. The lower Charlson scores observed in the protibial group could potentially influence these favourable outcomes, warranting further prospective studies to validate these findings and to guide treatment decisions for elderly patients with ankle fractures.
