Early weight bearing in elderly patients with ankle fractures reduces care needs and maintains independence.

BACKGROUND: Ankle fractures in the elderly are increasingly prevalent and are associated with significant morbidity and loss of independence. METHOD: Patients over the age of 70 suffering ankle fracture were identified using ICD-9-CM patient coding. Fracture stability was assessed using patient records and radiographic evidence. Management strategy, length of inpatient stay, time non-weight bearing, pre-admission residence, discharge destination and discharge care needs were studied. RESULTS: 169 patients with a mean age 80.3 years were studied. Management strategy was shown to have a significant effect on a patient's care requirements (p = 0.012) and ability to return to their primary residence (p = 0.014). Management via an intramedullary rod was associated with the lowest rates of increased care needs (29.7%) and the highest rate of returning home on discharge (88.9%). CONCLUSIONS: Early weight bearing had a significant effect on a patient's ability to maintain independent living and were more likely to return to their own home.

Primary Jejunal Enterolith Causing Small Bowel Obstruction Without Any Underlying Bowel Abnormality.

Enterolith formation is a rare condition precipitated by decreased bowel motility. It may cause obstruction or other complications and the diagnosis usually is confirmed after surgery and analysis of the stones or fragments. It is often seen in association with intestinal abnormalities such as diverticula and inflammation or in biliary tract fistulas where stones migrate to the duodenum and small bowel. We report an unusual case of a primary true enterolith formation in a patient without any underlying bowel condition or any previous surgery.