Summary
Only two reports have prospectively examined outcome in the treatment of ankle fractures
among elderly patients, and the criteria for treatment were different between the
studies. With respect to individual outcome parameters, one study reported no difference
in pain scores between nonoperative versus operative treatment, but better scores
for swelling and activities such as running, jumping, and taking stairs among patients
treated operatively. Another study, which used a different scoring tool for clinical
assessment, reported better function and pain scores among patients treated nonoperatively.
Patients treated operatively tended to have longer hospital stays in both studies.
Complications varied between studies, in part due to a lack of consistency in defining
a complication. There is some evidence to suggest that among patients whose fractures
are successfully reduced initially by closed reduction, a relatively large proportion
will lose reduction and go on to malunion or nonunion if treated nonoperatively. Further
research is required to verify this finding.
