Abstract
In forefoot surgery, the presenting complaints and expected benefits differ between
elderly and younger patients. The present study mapped forefoot procedures recommended
to elderly patients compared with those recommended to the general population and
assessed the complications according to age group and comorbidity. Consecutive patients
were included in a single-center, continuous, retrospective case-control study. Three
age groups were defined: <65 years, 65 to 74 years, and ≥75 years. All patients, regardless
of age, underwent the same procedure; elderly-specific techniques such as the Keller
procedure were not used. A total of 321 patients were included, with a mean age of
60.6 (range 16 to 86) years. A similar procedure was used in all 3 groups, but at
differing frequencies, with arthrodesis and minor procedures increasing with increasing
patient age. In all 3 groups, in the population as a whole, the incidence of delayed
healing, deep infection, and nonunion was 9%, 1%, and 2%, respectively. These complications
were independent of age group. In the <65-year-old group, just as in the study population
as a whole, arthrodesis associated with resection arthroplasty resulted in greater
rates of delayed healing and deep infection. The complications rates were equivalent
among the 3 age groups. Major surgical procedures should be avoided in elderly patients,
if possible. However, no particular procedure is contraindicated in the elderly, although
the method of fixation must be robust owing to the frequency of osteoporosis. A first
step would be to achieve consensus on the age threshold for “elderliness.”
Level of Clinical Evidence
Keywords
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Article info
Publication history
Published online: December 02, 2014
Footnotes
Financial Disclosure: Jean-Luc Besse is a consultant for Biotech International.
Conflict of Interest: None reported.
Identification
Copyright
© 2015 American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.
