Prospektiv randomisierte Studie zum Vergleich von winkelstabilen Plattenosteosynthesen mit konventionellen Drittelrohrplatten bei geriatrischen OSG-Frakturen hinsichtlich der Frühkomplikationen

Over a period of 3 years, at fixed follow-up intervals of 6 and 12 weeks, 6 and 12 months, we examined 75 geriatric patients who initially presented at our UKGM Marburg hospital with a fracture of the ankle joint and were accordingly treated with a locking plate or an one-third tube plate. The main focus of this study was on the early complications/ short-term complications, as well as the functional outcome and quality of life after 6 weeks postoperatively. The question was whether one of the two plates used could be superior. The evaluation of our study data showed an overall postoperative complication rate of 20%, which is within the expected range based on the current knowledge. Wound healing disorders of various degrees were the most frequently recorded complications, accounting for 53.3% of all complications. We found significantly more wound complications in the group treated with locking plates (n=37). In this patient group, a significantly higher use of so called Fixateur externe in the initial treatment of the fracture has also been recorded so far. In addition, we were able to determine that there were decisive differences between the two compared groups. Comparing between the initial examination and the first follow-up examination 6 weeks postoperatively. In the group with locking plates, the AOFAS score in total and the subcategory of the AOFAS score regarding the function were significantly better than in the treatment with one-third tube plate. In addition, the EQ5D index was also significantly less reduced in the locking plate group compared from admission to 6 weeks postoperatively than in the patientswith conventional plating. Apart from this, we could not detect any significant differences, not even with regard to demographic parameters or associations with severe comorbidities. We conclude that locking plates should play a more relevant role in the treatment of geriatric ankle fractures. This means that our results should be incorporated into the treatment options offered to geriatric patients and that they should be given an appropriate status. Especially in the context that the population continues to grow older and the demand for functionality, activity and social participation continues to increase into old age. However, one should not disregard the clearly higher wound complication rate in connection with the use of locking plates. This is quite relevant and for this reason, among others, further investigations and studies on this topic should definitely be carried out. In view of the fact that there are only a few studies to date on the optimal treatment of geriatric ankle fractures, especially with regard to the use of locking plates. There should be more studies on this topic in the future, in addition to this study carried out here and also for a better classification and understanding of our results.