Abstract：
BACKGROUND: This article is a systematic review of the literature on elderly aged 80 and over with an ankle fracture. Low energy trauma fractures are a major public health burden in developed countries that have aged populations. Ankle fractures are the third most common fractures after hip and wrist fractures. The purpose of this review is to provide an overview of the treatments and the used outcome factors.
METHODS: PubMed, Embase, Cochrane Library, and CINAHL were searched to retrieve relevant studies. Studies published in English or Dutch concerning the treatment of ankle fractures in patients aged 80 and over were included.
RESULTS: Initially 2054 studies were found in the databases. After removing duplicate entries, 1182 remained. Finally, after screening six studies were included, of which three cohorts studies and three case series. Six different treatments were identified and described; ORIF, transarticular Steinmann pin, plaster cast with or without weight-bearing, Gallagher nail and the TCC nail. Furthermore, 32 outcome factors were identified.
CONCLUSIONS: The various studies show that practitioners are careful with early weight-bearing. However, if we look closely to the results and other literature, this seems not necessary and it could potentially be of great value to implement early weight-bearing in the treatment. Furthermore, quality of life seems underreported in this research field.
CONCLUSIONS: ORIF with plaster cast and permissive weight-bearing should be considered for this population since it seems to be a safe possibility for a majority of the relatively healthy patients aged 80 and over. In cases where surgery is contra-indicated and a plaster cast is the choice of treatment, early weight-bearing seems to have a positive influence on the outcome in the very old patient.
METHODS: PubMed, Embase, Cochrane Library, and CINAHL were searched to retrieve relevant studies. Studies published in English or Dutch concerning the treatment of ankle fractures in patients aged 80 and over were included.
RESULTS: Initially 2054 studies were found in the databases. After removing duplicate entries, 1182 remained. Finally, after screening six studies were included, of which three cohorts studies and three case series. Six different treatments were identified and described; ORIF, transarticular Steinmann pin, plaster cast with or without weight-bearing, Gallagher nail and the TCC nail. Furthermore, 32 outcome factors were identified.
CONCLUSIONS: The various studies show that practitioners are careful with early weight-bearing. However, if we look closely to the results and other literature, this seems not necessary and it could potentially be of great value to implement early weight-bearing in the treatment. Furthermore, quality of life seems underreported in this research field.
CONCLUSIONS: ORIF with plaster cast and permissive weight-bearing should be considered for this population since it seems to be a safe possibility for a majority of the relatively healthy patients aged 80 and over. In cases where surgery is contra-indicated and a plaster cast is the choice of treatment, early weight-bearing seems to have a positive influence on the outcome in the very old patient.
摘要：
背景：本文是对80岁及以上老年人踝关节骨折相关文献的系统综述。低能量创伤骨折是老年人口发达国家的主要公共卫生负担。踝关节骨折是仅次于髋部和腕部骨折的第三大常见骨折。这篇综述的目的是提供治疗和使用的结果因素的概述。
方法：PubMed，Embase,科克伦图书馆,搜索和CINAHL以检索相关研究。包括以英语或荷兰语发表的有关80岁及以上患者踝关节骨折治疗的研究。
结果：最初在数据库中发现了2054项研究。删除重复条目后，还有1182。最后,经过筛选，纳入了六项研究，其中三个队列研究和三个病例系列。确定并描述了六种不同的治疗方法；ORIF，经关节Steinmann别针,石膏铸造有或没有承重，Gallagher指甲和TCC指甲.此外，确定了32个结果因素。
结论：各种研究表明，从业者对早期负重非常谨慎。然而,如果我们仔细观察结果和其他文献，这似乎没有必要,并且可能对在治疗中实施早期负重具有重要价值.此外，在这个研究领域，生活质量似乎被低估了。
结论：对于该人群，应考虑使用石膏模型和允许负重的ORIF，因为对于大多数80岁及以上的相对健康的患者来说，这似乎是一种安全的可能性。如果手术是禁忌症，石膏是治疗的选择，早期负重似乎对高龄患者的预后有积极影响.
方法：PubMed，Embase,科克伦图书馆,搜索和CINAHL以检索相关研究。包括以英语或荷兰语发表的有关80岁及以上患者踝关节骨折治疗的研究。
结果：最初在数据库中发现了2054项研究。删除重复条目后，还有1182。最后,经过筛选，纳入了六项研究，其中三个队列研究和三个病例系列。确定并描述了六种不同的治疗方法；ORIF，经关节Steinmann别针,石膏铸造有或没有承重，Gallagher指甲和TCC指甲.此外，确定了32个结果因素。
结论：各种研究表明，从业者对早期负重非常谨慎。然而,如果我们仔细观察结果和其他文献，这似乎没有必要,并且可能对在治疗中实施早期负重具有重要价值.此外，在这个研究领域，生活质量似乎被低估了。
结论：对于该人群，应考虑使用石膏模型和允许负重的ORIF，因为对于大多数80岁及以上的相对健康的患者来说，这似乎是一种安全的可能性。如果手术是禁忌症，石膏是治疗的选择，早期负重似乎对高龄患者的预后有积极影响.
