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INTRODUCTION: There are increasing numbers of older persons sustaining ankle fractures. This injury often results in a degree of functional limitation, particularly in older patients. There is currently limited research into factors associated with mobility outcomes. DESIGN: Observational cohort study. SETTING: Hospital Trauma Department, UK. PARTICIPANTS: Persons aged 60 years or over who sustained an unstable ankle fracture with no established peripheral arterial disease pre-injury. METHODS: This study investigated the association between ankle-brachial pressure index (ABPI) and extended timed 'up and go' (TUG) measures. Associations between TUG outcomes and age, pre-morbid functional mobility (Olerud-Molander Ankle Score) and fracture severity (number of malleoli injured) were also explored. ANALYSIS: Complete cases (n=76; 84% of cohort) were entered into univariate and multivariate linear regression. RESULTS: No association was found between ABPI and TUG at 6 months in unadjusted and adjusted analyses. Pre-morbid functional mobility (B=-0.34, 95% confidence interval (CI) -0.45 to -0.23, p<0.001) and age (B=0.46, 95% CI 0.25-0.66, p<0.001) were associated with extended TUG values (r2=0.53, p<0.001). Fracture severity was not a significant independent predictor variable. CONCLUSIONS: Peripheral vessel function and fracture severity may have a limited independent influence on mobility outcome after ankle fracture in those patients who do not have established pre-injury peripheral arterial disease. Age and pre-morbid mobility gave an indication of mobility outcome, but a substantial amount of variance remains unexplained. Limitations of this study, including missing data and potential residual confounding, indicate the need for caution in generalising these results. The study provides a basis on which to plan larger studies of the factors associated with mobility outcome after ankle fracture in older populations.

Original publication

DOI

10.1016/j.injury.2012.08.042

Type

Journal article

Journal

Injury

Publication Date

07/2013

Volume

44

Pages

987 - 993

Keywords

Age Factors, Aged, Ankle Brachial Index, Ankle Fractures, Cohort Studies, Female, Fractures, Bone, Humans, Male, Middle Aged, Mobility Limitation, Peripheral Arterial Disease