Ankle fractures of the geriatric patient: a narrative review

Ziegler, Patrick; Bahrs, Christian; Konrads, Christian; Hemmann, Philipp; Ahrend, Marc-Daniel

doi:10.1530/eor-22-0082

Cited by 12 publications

(2 citation statements)

References 90 publications

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“…Decreased bone density and balance issues in this age group can not only increase the risk of injury but also prolong the healing process. [11,12] Additionally, the heightened sensitivity of elderly patients to injuries, coupled with a higher risk of complications, underscores the clinical significance of ankle injuries in this demographic. Thus, it is critical to factor in age-specific characteristics and needs when diagnosing and treating ankle injuries in geriatric patients.…”

Section: Discussionmentioning

confidence: 99%

The role of Ottawa ankle rules in geriatric emergency department visits

Seyhan

2024

Ulus Travma Acil Cerrahi Derg

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BACKGROUND: Ankle injuries are a common reason for visits to the emergency department (ED). An effective diagnosis and treatment process is crucial for the swift recovery of patients and for alleviating congestion in EDs. This study aims to evaluate the adequacy and effectiveness of the Ottawa Ankle Rules (OAR) in geriatric patients presenting to the emergency department (ED). METHODS:Between February 2022 and November 2022, 160 patients aged 65 and older (118 women, 42 men) who presented to the ED with isolated ankle injuries were included in the study. We calculated the sensitivity, specificity, positive predictive value, and negative predictive value of the OAR. RESULTS:The study found fractures in 37.5% of patients. The sensitivity of the OAR was 98.33%, the specificity was 86%, the negative predictive value was 98.85%, and the positive predictive value was 80.82%. CONCLUSION:This study demonstrates that the OAR is highly sensitive in the geriatric population but shows some limitations in terms of specificity and positive predictive value. These results support the effectiveness of using the OAR in evaluating ankle injuries in the geriatric population but also highlight the need for cautious application due to the potential for false-positive outcomes.

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Section: Discussionmentioning

confidence: 99%

The role of Ottawa ankle rules in geriatric emergency department visits

Seyhan

2024

Ulus Travma Acil Cerrahi Derg

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“…Bone fracture is a common injury and becomes a major source of disability, , which affects patient’s quality of life and imputes an immense socioeconomic burden. Although fractured bone can heal itself through direct bone union or indirect callus formation, 5–10% of bone fractures fail to heal and experience impaired healing (e.g., delayed healing or nonhealing) due to frequent complications, inadequate peripheral blood supply, osteoporosis, or certain cancers. − The treatment of impaired bone healing is cumbersome and the related patients usually undergo multiple undesired operations with a long treatment period. It is of great significance to accelerate fracture healing to improve the life quality of patient and reduce the economic burden on family.…”

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confidence: 99%

Bone Fracture Healing under the Intervention of a Stretchable Ultrasound Array

Liu,

Ding,

Lin

et al. 2024

ACS Nano

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Ultrasound treatment has been recognized as an effective and noninvasive approach to promote fracture healing. However, traditional rigid ultrasound probe is bulky, requiring cumbersome manual operations and inducing unfavorable side effects when functioning, which precludes the wide application of ultrasound in bone fracture healing. Here, we report a stretchable ultrasound array for bone fracture healing, which features high-performance 1−3 piezoelectric composites as transducers, stretchable multilayered serpentine metal films in a bridge-island pattern as electrical interconnects, soft elastomeric membranes as encapsulations, and polydimethylsiloxane (PDMS) with low curing agent ratio as adhesive layers. The resulting ultrasound array offers the benefits of large stretchability for easy skin integration and effective affecting region for simple skin alignment with good electromechanical performance. Experimental investigations of the stretchable ultrasound array on the delayed union model in femoral shafts of rats show that the callus growth is more active in the second week of treatment and the fracture site is completely osseous healed in the sixth week of treatment. Various bone quality indicators (e.g., bone modulus, bone mineral density, bone tissue/total tissue volume, and trabecular bone thickness) could be enhanced with the intervention of a stretchable ultrasound array. Histological and immunohistochemical examinations indicate that ultrasound promotes osteoblast differentiation, bone formation, and remodeling by promoting the expression of osteopontin (OPN) and runtrelated transcription factor 2 (RUNX2). This work provides an effective tool for bone fracture healing in a simple and convenient manner and creates engineering opportunities for applying ultrasound in medical applications.

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Advancing fracture management: the role of minimally invasive osteosynthesis in orthopedic trauma care

Wichlas,

Haybäck,

Hofmann

et al. 2024

Eur J Trauma Emerg Surg

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Purpose Minimally Invasive Osteosynthesis (MIO) developed to be a key technique in orthopedic trauma surgery, offering a less invasive alternative for managing fractures in various anatomical regions. However, standardized guidelines for its application are lacking. This study aims to establish comprehensive principles for MIO to guide surgeons in treating different types of fractures and its locations. Methods A retrospective analysis including 57 fractures in 53 patients was conducted. All patients were treated with MIO. Study range - March 2017 to January 2022 at a Level-I trauma university hospital. The analysis covered various fracture types, focusing on surgical approaches, reduction techniques, plate insertion methods, and its outcomes. The efficacy and safety of MIO was evaluated by analyzing complications, fracture healing time, and necessary revision surgeries. Results MIO is a versatile and effective fracture treatment that minimized soft tissue damage and ensured stable osteosynthetic results. Articular fractures typically used a “one way up” plate insertion technique, while non-articular fractures applied an “inside-up-and-down” approach. Low complication rates confirmed the safety and efficiency of MIO. Conclusion This research established generalized principles for MIO, offering a systematic approach that can be applied for various fracture types and its locations, by overall enhancing the surgical efficiency as well as patient recovery, without compromising outcomes. Level of evidence This study is classified as Level III evidence according to “The Oxford 2011 Levels of Evidence”.

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Ankle fractures of the geriatric patient: a narrative review

Cited by 12 publications

References 90 publications

The role of Ottawa ankle rules in geriatric emergency department visits

The role of Ottawa ankle rules in geriatric emergency department visits

Bone Fracture Healing under the Intervention of a Stretchable Ultrasound Array

Advancing fracture management: the role of minimally invasive osteosynthesis in orthopedic trauma care

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