Foot and Ankle Surgery: Considerations for the Geriatric Patient

Abstract

The growing number of lower-extremity abnormalities that are seen in inpatient and outpatient settings has paralleled the increased number of elderly in the population. Foot and ankle deformities, disorders, and arthritis, which are not manifested until late in life, have become more common as more individuals attain longer lifespans. Although conservative therapies are a priority when addressing the geriatric population, surgical options may be overlooked secondary to a misunderstanding of their ability to overcome perioperative management. Patients over the age of 65 are the fastest growing segment of the population; this population numbers more than 30 million people (Ͼ12.5% of the population).

Use of Prophylaxis for Prevention of Venous Thromboembolism in Patients with Isolated Foot or Ankle Surgery: A Systematic Review and Meta-Analysis

“…4,20,21 The resultant prolonged immobility may also lead into increased VTE risk in older adults. 7,8 Therefore, we made a priori plans to separately extract the results for older adults where available, especially given that the number of foot or ankle surgeries in older adults has risen recently and is projected to increase further. 22 In addition, we made a priori plan to explore the findings across the prophylaxis methods (pharmacological, mechanical, or hybrid).…”

“…Some experts consider these procedures to be associated with a procoagulant state, similar to other lower limb surgical procedures. Since immobility and nonweight bearing states have previously been shown to be risk factors for deep vein thrombosis (DVT) in foot and ankle surgery, 7,8 they believe that VTE prophylaxis should be part of the standard care for such patients. 9 Opposing views exist with others asserting that the rate of VTE after foot and ankle surgeries is small, and that there is no need for the routine use of VTE prophylaxis.…”

Forefoot Surgery in Elderly Compared With Younger Patient Populations: Complications and Type of Procedure

“…Even so, we treat our elderly patients as fragile, adapting, not the surgery itself, but the postoperative care, including nutrition, pharmacology, cardiovascular and pulmonary precautions, and anesthesia (27). Particular attention must be given to the elderly patient's cutaneous status, and dressings should be renewed by, or at least in the presence of, the surgeon.…”

Anthropometric evaluation of side, sex and age by radiological examination of the normal ankle joint among adult Egyptian population

“…For example, with age, bones lose their strength and rigidity; in addition, they become more brittle. Furthermore, joints and surrounding soft tissue become less flexible and weaker (Lee & Mulder, 2009).…”