[Full weight-bearing after geriatric ankle fractures-No problem?]

Abstract

As the population ages the incidence and complexity of ankle fractures in older adults are increasing; however, treating this older population presents particular challenges. One of these challenges is the postoperative treatment as older adults are often unable to perform partial weight-bearing. This article reviews the current literature on the reality of care and the impact of postoperative rehabilitation on functional outcomes and complication rates in older adults. The current state of care was analyzed based on recent, high-quality studies on the surgical management of ankle fractures. In the vast majority of these studies, restrictive postoperative protocols involving partial or complete weight-bearing restrictions in combination with immobilization were employed. In 14 (quasi)randomized studies different postoperative protocols were compared, including patients over the age of 65 years. Early protective full weight-bearing, compared to non- or partial weight-bearing, led to significantly better short-term (up to 3 months) subjective treatment outcomes in 7 out of 10 studies. Early functional treatment did not lead to an increase in the complication rate in any of the included studies; however, there is a lack of studies focusing exclusively on a geriatric patient population. Accordingly, high-quality studies specifically analyzing geriatric patients are urgently needed. Nevertheless, the existing studies support the trend toward early full weight-bearing and mobilization.