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Published in: International Orthopaedics 2/2018

01-02-2018 | Original Paper

Standardised pre-operative diagnostics and treatment of peripheral arterial disease reduce wound complications in geriatric ankle fractures

Authors: René Aigner, Philipp Lechler, Christoph Kolja Boese, Benjamin Bockmann, Steffen Ruchholtz, Michael Frink

Published in: International Orthopaedics | Issue 2/2018

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Abstract

Purpose

The aim of this study was to evaluate a standardised algorithm to assess and treat impaired limb perfusion prior to surgical fixation of geriatric ankle fractures and determine the prevalence of peripheral arterial disease (PAD) in geriatric patients presenting with ankle fractures.

Methods

Eighty-four patients >65 years pre-operatively diagnosed and treated according to an algorithm (study group) were compared with 84 patients diagnosed and treated before the algorithm was introduced (control group).

Results

In 14 patients of the study group, clinical noninvasive examination revealed signs of relevant PAD, which was confirmed with computed tomographic angiography (CTA) in nine patients, all of whom had successful angioplasty prior to surgical fixation of the ankle fracture. In three of these patients, PAD had previously been diagnosed. After standardised diagnostics and treatment of malperfusion, a significantly reduced overall and, particularly, wound complication rate was found.

Conclusion

PAD is an underdiagnosed condition in geriatric patients presenting with ankle fractures. This study underlines the relevance of limb perfusion for adequate wound healing in geriatric ankle fractures. Therefore, special attention should be paid to diagnose and—if indicated—optimise limb perfusion prior to surgical fixation of geriatric ankle fractures.
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Metadata
Title
Standardised pre-operative diagnostics and treatment of peripheral arterial disease reduce wound complications in geriatric ankle fractures
Authors
René Aigner
Philipp Lechler
Christoph Kolja Boese
Benjamin Bockmann
Steffen Ruchholtz
Michael Frink
Publication date
01-02-2018
Publisher
Springer Berlin Heidelberg
Published in
International Orthopaedics / Issue 2/2018
Print ISSN: 0341-2695
Electronic ISSN: 1432-5195
DOI
https://doi.org/10.1007/s00264-017-3705-x

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