scholarly journals Postoperative Complications and Reoperation Rates Following Open Reduction and Internal Fixation of Ankle Fracture

Joints ◽  
2018 ◽  
Vol 06 (02) ◽  
pp. 110-115 ◽  
Author(s):  
Armando Macera ◽  
Christian Carulli ◽  
Luigi Sirleo ◽  
Massimo Innocenti
Keyword(s):  
Surgical Treatment ◽  
Postoperative Complications ◽  
Internal Fixation ◽  
Surgical Procedure ◽  
Ankle Fracture ◽  
Open Reduction ◽  
Impaired Wound Healing ◽  
Major Complications ◽  
And Function ◽  
Reoperation Rates

Purpose The purpose of this study was to determinate the overall postoperative complication and reoperation rates related to open reduction and internal fixation (ORIF) of ankle fractures. Methods All patients who had undergone an ankle fracture operation at our institution from January 2005 through December 2013 were identified by querying the hospital surgical procedure database for diagnoses codes. Medical records, surgical procedure, and outpatient control reports were reviewed to collect pre-, intra-, and postoperative details. All data obtained were retrospectively analyzed by the authors to evaluate the postoperative complications and the type of further surgical treatment required to treat them. Results A total of 378 consecutive patients were included in the study. Overall complications rate was 36.0%. Minor complications (4.5%) were represented by superficial infection (1.3%) and impaired wound healing (3.2%). All these patients required advanced wound care and prolonged oral antibiotics. Major complications (31.5%) included: residual pain (17.2%), deep infection (3.4%), malunion (2.4%), posttraumatic ankle osteoarthritis (5.0%), implant breakage (0.3%), complex regional pain syndrome (1.3%), and arthrofibrosis (1.9%). Note that 21.7% of major complications required further surgical procedure. Reoperations included arthroscopic debridement (15.1%), hardware removal and debridement of all necrotic tissue (4.5%), and ankle fusion (2.1%). Surgery was necessary mainly for pain removal and function recovery. Conclusion Ankle fracture ORIF represents a satisfying surgical treatment. Nevertheless, postoperative complications are not uncommon. Minor complications can be easily managed with medications and repeated outpatient controls. Reoperation is occasionally required to treat major complications. Revision surgery is mandatory to ensure pain relief and function improvement. Level of Evidence Level II, retrospective cohort study.

Association of Bleeding Disorders and Risk of Complications Following Open Reduction and Internal Fixation of the Ankle

2021 ◽  
pp. 107110072110581
Author(s):  
Alisa Malyavko ◽  
Theodore Quan ◽  
William T. Stoll ◽  
Joseph E. Manzi ◽  
Alex Gu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Postoperative Complications ◽  
Internal Fixation ◽  
Operative Treatment ◽  
Ankle Fracture ◽  
Open Reduction ◽  
Bleeding Disorder ◽  
Ankle Fractures ◽  
Bleeding Disorders ◽  
Increased Risk

Background: Open reduction and internal fixation (ORIF) of the ankle is a common procedure performed to correct ankle fractures in many different patient populations. Diabetes, peripheral vascular disease, and osteoporosis have been identified as risk factors for postoperative complications following surgery for ankle fractures. To date, there have not been any studies evaluating postoperative outcomes in patients with bleeding disorders undergoing operative treatment for ankle fractures. The aim of this study was to determine the postoperative complication rate following ORIF of the ankle in patients with a bleeding disorder vs those without a bleeding disorder. Methods: From 2006 to 2018, patients undergoing operative treatment for ankle fracture were identified in the National Surgical Quality Improvement Program database. Two patient cohorts were defined: patients with a bleeding disorder and patients without a bleeding disorder. Patients who underwent either inpatient or outpatient ORIF of the ankle were included in this study. In this analysis, demographics, medical comorbidities, and postoperative complications variables were assessed between the 2 cohorts. Bivariate and multivariate analyses were performed. Results: Of 10 306 patients undergoing operative treatment for ankle fracture, 9909 patients (96.1%) had no bleeding disorder whereas 397 patients (3.9%) had a bleeding disorder. Following adjustment on multivariate analysis, compared to patients who did not have a bleeding disorder, those with a bleeding disorder had an increased risk of any postoperative complications (odds ratio [OR] 1.48, 95% confidence interval [CI] 1.05-2.08, P = .024), requirement for postoperative blood transfusion (OR 2.86, 95% CI 1.53-5.36, P = .001), and extended length of hospital stay greater than 5 days (OR 1.46, 95% CI 1.10-1.93, P = .010). Conclusion: Patients with bleeding disorders are associated with increased risk of postoperative complications following ORIF for ankle fractures. Determining patient risk factors and creating optimal preoperative and perioperative management plans in patients with bleeding disorders undergoing ORIF can be beneficial in reducing postoperative complications, improving patient outcomes, and reducing overall morbidity. Level of Evidence: Level III, retrospective cohort study.

scholarly journals Two-stage open reduction and internal fixation versus limited internal fixation combined with external fixation: a meta-analysis of postoperative complications in patients with severe Pilon fractures

2018 ◽  
Vol 46 (7) ◽  
pp. 2525-2536 ◽  
Author(s):  
Xueliang Cui ◽  
Hui Chen ◽  
Yunfeng Rui ◽  
Yang Niu ◽  
He Li
Keyword(s):  
Postoperative Complications ◽  
Internal Fixation ◽  
Bone Healing ◽  
Open Reduction ◽  
Lower Risk ◽  
Meta Analysis ◽  
Two Stage ◽  
Superficial Infection ◽  
Tibial Pilon ◽  
Pilon Fractures

Objectives Two-stage open reduction and internal fixation (ORIF) and limited internal fixation combined with external fixation (LIFEF) are two widely used methods to treat Pilon injury. However, which method is superior to the other remains controversial. This meta-analysis was performed to quantitatively compare two-stage ORIF and LIFEF and clarify which method is better with respect to postoperative complications in the treatment of tibial Pilon fractures. Methods We conducted a meta-analysis to quantitatively compare the postoperative complications between two-stage ORIF and LIFEF. Eight studies involving 360 fractures in 359 patients were included in the meta-analysis. Results The two-stage ORIF group had a significantly lower risk of superficial infection, nonunion, and bone healing problems than the LIFEF group. However, no significant differences in deep infection, delayed union, malunion, arthritis symptoms, or chronic osteomyelitis were found between the two groups. Conclusion Two-stage ORIF was associated with a lower risk of postoperative complications with respect to superficial infection, nonunion, and bone healing problems than LIFEF for tibial Pilon fractures. Level of evidence 2.

Acute compartment syndrome of the foot following open reduction and internal fixation of an ankle fracture

Injury ◽  
2015 ◽  
Vol 46 (10) ◽  
pp. 2064-2068 ◽  
Author(s):  
David Neilly ◽  
Santosh Baliga ◽  
Christopher Munro ◽  
Andrew Johnston
Keyword(s):  
Internal Fixation ◽  
Compartment Syndrome ◽  
Ankle Fracture ◽  
Open Reduction ◽  
Acute Compartment Syndrome

scholarly journals SURGICAL TREATMENT OF CLAVICULAR FRACTURES IN SPORT

2018 ◽  
Vol 6 (6_suppl3) ◽  
pp. 2325967118S0004
Author(s):  
E Gastaldi Orquin ◽  
GM Gastaldi Llorens
Keyword(s):  
Surgical Treatment ◽  
Internal Fixation ◽  
Open Reduction ◽  
Plate Osteosynthesis ◽  
Platelet Rich Plasma ◽  
Plate Fixation ◽  
Activity Level ◽  
Contact Sports ◽  
Sport Practice ◽  
Shoulder Range Of Motion

Clavicular fractures are common in sport practice, they are easily diagnosed and have a relative good forecast. Nevertheless there is no consensus among orthopedic surgeons regarding treatment for displaced midle-third clavicular fractures (Robinson’s classification 2B2) and lateral-third fractures. The tendency toward operative treatment is increasing due to the earlier sport recovery. Objectives: The aim of the paper is to present the results of treatment of 98 clavicular fractures in the Clinic Gastaldi of Traumatology during the period from 1997 to 2016, analyzing the radiologic and clinical results. Methods: The serie consists of 89 patients, 80 males and 9 females, average age 32.2 years. From them, 89 were agude fractures and 9 nonunion (after conservative treatment). According to the Thomsom classification there were 82 middle-third and 16 lateral-third. Motorbike sport trauma was the cause of 49 patients (55%), bike trauma in 18 (20%), 18 (20%) fractures occurred due to contact sports and 3 other causes. All patients were surgically treated. We used an antero-superior approach, open reduction and internal fixation with antero-superior plate osteosynthesis. In case of nonunion we decorticated the fracture callus, adding intramedullary reaming and graft bone. PRP (Platelet Rich-Plasma) was used in 8/9 patients. Postoperatively, the patients were placed in a sling. After that they began a rehabilitation program that consists of isometrics, pendular and active movements until 45° during 3 weeks. From 4th to 6th week, active movements until 90°. The patients began free movements after the 6th week. Results: Fracture healing mean was 10 weeks. Bikes and motorbikes were able to ride again between 10 to 21 days after surgery (once removed stitches). All patients retrieved full shoulder range of motion and returned to their previous activity level. Complications: we had no nonunion rates after surgical treatment, neither infections. 1 case of insufficient plate fixation and 4 re-fractures which required surgical treatment. Conclusion: We suggest surgical treatment for clavicular fractures in adult patients, contact sports with IIB and IIIB fractures, re-fractures and painful nonunion. Surgical treatment with open reduction and internal fixation (ORIF) of displaced middle-third clavicular fractures achieved shorter time to complete return to sport and earlier bone union.

Surgical Treatment of Calcaneal Fractures with Use of β-Tricalcium Phosphate Ceramic Grafting

2008 ◽  
Vol 29 (10) ◽  
pp. 1015-1019 ◽  
Author(s):  
Sheng-Dan Jiang ◽  
Lei-Sheng Jiang ◽  
Li-Yang Dai
Keyword(s):  
Surgical Treatment ◽  
Internal Fixation ◽  
Tricalcium Phosphate ◽  
Open Reduction ◽  
Clinical Results ◽  
Statistical Correlation ◽  
Calcaneal Fractures ◽  
Retrospective Case ◽  
Level Of Evidence ◽  
The Mean

Background: The treatment of calcaneal fractures is challenging. Internal fixation and grafting with sintered β-tricalcium phosphate (β-TCP) ceramic is alternative to bone grafting in the treatment of calcaneal fractures. Methods: Seventy-four patients with intraarticular calcaneal fractures were treated with open reduction, internal fixation and grafting with sintered β-TCP ceramic. Followup was performed using the Maryland foot score as well as plain radiography. Results: All patients were followed for 15 (range, 12 to 26) months. Clinical results as assessed by the Maryland foot score were excellent in 40 of 74 cases (54.1%), good in 28 (37.8%), and fair in 6 (8.1%). Immediately after surgery, the mean Böhler angle was improved by 23 degrees, and 1 year after surgery, the mean Böhler angle decreased by 4 degrees. A similar change was also seen in Gissane angles and the height and width of the calcaneus. There was no statistical correlation between the severity of fracture and functional outcome in this series. All fractures healed. Conclusion: These findings suggest that use of β-TCP combined with open reduction and internal fixation is an effective and safe method for the surgical treatment of intra-articular calcaneal fractures. Level of Evidence: IV, Retrospective Case Study

Sign in / Sign up

Export Citation Format

Share Document