They also showed an increase in the more severe Lauge-Hansen supination-eversion stage 4 ankle fracture, compared with more stable ankle fracture patterns. 1 Kannus and associates 2 reported that the number of ankle fractures in Finnish patients older than 70 years increased 3-fold between 19. In the United States, ankle fractures have been reported to occur in as many as 8.3 persons per 1000 Medicare recipients. Ankle fractures are common in older patients, and both their incidence and severity have increased significantly in this patient population during the past 30 years. Management of ankle fractures in older patients is a growing problem that affects the practices of both orthopedic surgeons and primary care physicians. Orthopedic surgeons and primary care physicians need understanding of the risk factors associated with ankle fractures in older patients as well as appropriate evaluation and management strategies. However, the presence of osteoporosis may increase the complexity of these cases, potentially requiring alteration of standard operative techniques. The literature supports operative intervention for displaced ankle fractures in older patients. Operative fixation is widely accepted as the proper treatment for younger patients, but the optimal treatment for older patients is less clear. These fractures are characterized as fragility fractures associated with osteoporosis, but propensity for falls, increased weight, and polypharmacy may be bigger risk factors than poor bone quality. ABSTRACT: The incidence of ankle fractures in the older patient population is rising.
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