Unstable Ankle Fracture in Patients Over 60 — When Cast Reduction Can Be Maintained

In adults over 60 years of age presenting with an unstable ankle fracture, the choice between surgical fixation and non-operative management requires careful consideration. When fracture reduction can be maintained by cast, a non-surgical pathway may be appropriate.

Clinical Scenario

        Patient age over 60 · Unstable ankle fracture · Reduction maintainable by cast
      

Older patients with ankle fractures often have reduced bone density and compromised soft tissue quality. These factors influence how well surgical repair holds and how wounds heal, making the risk-benefit profile of operative management different from that of younger patients.

Treatment Approach

A non-operative cast-based technique is recognised as a viable alternative to surgery in this patient group when the fracture reduction can be adequately held. The full protocol specifies the method and management pathway.

Instant Access to Structured Evidence-Based Regimens

References

DOI: 10.1177/1750458920988162

The BOA recommends close contact casts for patients over 60 years of age as an alternative to surgery if reduction can be maintained by the cast.

These patients exhibit poor bone and soft tissue quality which leads to poor surgical outcomes.

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