Early weight-bearing after ankle fixation may be beneficial in older patients
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Key takeaways:
- Results showed no association between early weight-bearing and major complications after open reduction and internal fixation for unstable ankle fractures.
- However, patients experienced 14 minor complications.
LOUISVILLE, Ky. — Data presented here showed early postoperative weight-bearing after open reduction and internal fixation for unstable ankle fractures was not associated with major complications among older patients.
“From this study, we can see that geriatric patients who underwent early postoperative weight-bearing after ankle open reduction and internal fixation had no major complications and a relatively small number of soft tissue complications,” Valerie Carbajal, MD, said in her presentation at the American Orthopaedic Foot & Ankle Society Annual Meeting.
Carbajal and colleagues retrospectively collected patient demographics, comorbidities, Lauge-Hansen classification, concomitant injuries, times to weight-bearing, method of fixation and adverse outcomes among 112 patients older than 60 years who underwent open reduction and internal fixation (ORIF) for unstable ankle fractures between 2015 and 2022. Carbajal said patients remained weight-bearing at 50% for 2 to 3 weeks postoperatively for incisional healing before progressing to weight-bearing as tolerated after suture removal.
“Outcomes included fracture union and healing, radiographic maintenance of alignment, hardware failure, wound complications and the need for revision surgery,” Carbajal said.
Researchers found patients experienced no major complications, such as hardware failure, gross loss of reduction, need for revision or accelerated posttraumatic arthritis, after early postoperative weight-bearing. However, Carbajal said patients had 14 minor complications, including delayed wound healing, surgical site infections and hardware removal for symptomatic hardware.
“This data supports a growing trend toward early postoperative weight-bearing after ankle ORIF, which is especially pertinent in an aging population that needs to weight-bear early and avoid prolonged immobilization,” Carbajal said.
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Carbajal V, et al. Outcomes of early weight-bearing following open reduction and internal fixation in the geriatric population. Presented at: American Orthopaedic Foot & Ankle Society Annual Meeting; Sept. 20-23, 2023; Louisville, Kentucky.
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