Surgical Management of Geriatric Ankle Fractures

There is a perpetual increase in the number of elderly people in the United States, both as a function of raw population size, and improvements in health care and its delivery. As such, it is our duty as foot and ankle surgeons to be participants in the improvement of geriatric health care. One area that has garnered burgeoning interest is geriatric ankle fractures. Typically managed nonoperatively, new evidence has supported surgical management of these fractures to spare morbidity and mortality. Classically, a lag screw and one-third tubular plate construct for the fibula and long lag screws in the medial malleolus was the mainstay of surgical treatment. This review paper looks at newer technologies and techniques, including fibular locking plates, fibular intramedullary nails, hindfoot fusion nails, and external fixation as important surgical techniques to hone in patients who often have diminished bone quality and wound-healing capabilities. Understanding these surgical modalities is a vital component in managing geriatric ankle fractures successfully.