ABSTRACT
RESUMEN Introducción: El tratamiento de las fracturas del tobillo tiene importancia en la recuperación de la movilidad e independencia del paciente geriátrico. Objetivo: Evaluar el resultado obtenido al transcurrir un año del tratamiento quirúrgico mediante reducción y fijación de las fracturas inestables en pacientes mayores de 65 años. Métodos: Estudio descriptivo y prospectivo; pacientes mayores de 65 años, atendidos entre enero de 2017 y diciembre de 2018 por fractura de tobillo desplazada, en el Hospital Universitario General Calixto García Íñiguez y el Centro de Investigaciones en Longevidad, Envejecimiento y Salud, que fueron evaluados un año después. Resultados: De un total de 31 pacientes, 6 hombres y 25 mujeres con una edad media de 73,4 ± 3,5 años, 12 presentaban deterioro cognitivo, 18 llevaban terapia anticoagulante y 14 ingerían más de cuatro medicamentos diariamente. Predominaron los grupos con 3 y 4 puntos del índice de Charlson, la mayoría se ubicó en ASA III de riesgo anestésico y fracturas Dannis-Weber tipo C, 29 fracturas fueron cerradas. Las complicaciones fueron escasas; 27 de 31 pacientes se ubicaron como excelente o bueno según la escala AOFAS; 3 ± 2 en la escala visual de dolor; 86 por ciento podían realizar sus actividades de la vida diaria, Conclusiones: El resultado del tratamiento quirúrgico de las fracturas de tobillo en mayores de 65 años fue bueno y con baja incidencia de complicaciones que pueden relacionarse con condiciones mórbidas previas(AU)
ABSTRACT Introduction: The ankle fracture treatment is important in the recovery of mobility and independence of geriatric patients. Objective: To evaluate the results after one year of surgical treatment by reduction and fixation of unstable fractures in patients older than 65 years. Methods: A descriptive and prospective study was carried out in patients older than 65 years, treated from January 2017 to December 2018 due to displaced ankle fracture, at General Calixto García Íñiguez University Hospital and the Research Center for Health, Longevity and Aging. These patients were assessed a year later. Results: Out of a total of 31 patients, 6 men and 25 women with a mean age of 73.4 ± 3.5 years, 12 had cognitive impairment, 18 were on anticoagulant therapy and 14 were taking more than four medications daily. Groups with 3 and 4 points of Charlson index predominated, the majority were located in ASA III of anesthetic risk and Dannis-Weber type C fractures, 29 fractures were closed. Complications were rare and 27 out of 31 patients ranked as excellent or good according to the AOFAS scale, 3 ± 2 on the visual pain scale, 86 percent of performing activities of their daily life. Conclusions: The result of the surgical treatment of ankle fractures in people older than 65 years was good and with a low incidence of complications that may be related to previous morbid conditions(AU)
Subject(s)
Humans , Male , Female , Aged , Ankle Fractures/surgery , Fracture Fixation/methods , Epidemiology, Descriptive , Prospective Studies , Treatment Outcome , Observational StudyABSTRACT
Objective To compare the influence of early weight bearing exercise and plaster fixed method on postoperative function and fracture healing of unstable ankle fracture patients.Methods 50 cases of unstable ankle fracture patients who did surgical treatment in our hospital were selected as the research object,and were randomly divided into an observation group and a control group.The observation group was applied with early postoperative weight bearing exercise,while the control group patients was applied with postoperative plaster fix with 2 weeks.The postoperative function and fracture healing situation of both groups were compared.Results At postoperative 24 hours and 1 week,the perimeter difference of two groups were not statistically different (P＞0.05).At postoperative 6 weeks,the perimeter difference was (0.53 ±0.31) cm in the observation group and (1.25±0.47)cm in the control group,the comparative differences was statistical significance (t=6.39,P＜0.05).The total effective rate of alleviate swelling in the observation group at postoperative 6 weeks was 96.0％,which was higher than that of the control group (76.0％) with statistical difference (x2=4.15,P＜0.05).At postoperative 24 hours,postoperative 1 week and postoperative 6 weeks,the pain index comparison difference between the two groups was not statistically significant (P＞0.05).The Baird-Jackson score of the observation group at postoperative 3 months was not different with the control group with statistically significant (P＞0.05) ; At the postoperative 6 months,the Baird-Jackson score of the observation group was (95.21 ± 8.25),which was higher than that in the control group (82.52±6.96) with statistical difference (t=5.88,P＜0.05).Conclusion The early weight bearing exercise can promote haemal circumfluence,relieve swelling,and be helpful for function recovery and fracture healing of unstable ankle fracture patients.