Open ankle fractures: Factors influencing unplanned reoperation |
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| Affiliation: | 1. Health Education England North East, Newcastle Upon Tyne, United Kingdom;2. Department of Trauma and Orthopaedics, Royal Victoria Infirmary, Newcastle Upon Tyne, United Kingdom;1. Department of Emergency Medicine, Seoul National University College of Medicine and Hospital, 20 Boramae-Ro 5 gil, Dongjak-gu, Seoul 07061, Republic of Korea;2. Department of Emergency Medicine, Seoul National University Boramae Medical Center, Republic of Korea;3. Department of Emergency Medicine, Seoul National University Bundang Hospital, Republic of Korea;1. Department of Osteology and Biomechanics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany;2. Department of Pediatric Orthopaedics Surgery, Children''s Hospital Hamburg-Altona, Bleickenallee 38, Hamburg 22763, Germany;3. Department of Orthopaedics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany;4. Department of Pediatric Surgery, Klinik St. Hedwig, University Medical Center Regensburg, Regensburg, Germany;1. Division of Orthopaedic Surgery, St. Michael''s Hospital, 55 Queen Street East, Suite 800, Toronto, ON M5C 1R6, Canada;2. Faculty of Medicine, University of Toronto, Toronto, Canada;3. University of Western Ontario, London, Canada;1. Dept. of Orthopaedic and Trauma Surgery, Lucerne Cantonal Hospital, Luzern, Switzerland;2. Dept. of Trauma Surgery, Maasstad Hospital, Rotterdam, the Netherlands;3. Dept. Health Science and Medicine, University of Lucerne, Switzerland |
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| Abstract: | IntroductionAnkle fractures are amongst the most common open fracture injuries presenting to major trauma centres (MTC) and their management remains a topic of debate. Incidence is increasing particularly in the elderly population however the optimal surgical approach and risk factors for unplanned reoperation remain scarce. We therefore conducted a retrospective case study to analyse our institution's outcomes as well as identify risk factors for early unplanned reoperation.Materials and methodsSixty-five consecutive open ankle fractures were identified using our institutional database between July 2016 and July 2020. Medical records and operation notes were reviewed to identify patient age at injury, Sex, co-morbidities and other co-morbidities, fracture configuration, extent of soft tissue injury, fixation type and post-operative complications. The data was categorised into four groups for analysis, 1) age, 2) AO-OTA classification 3) Sex 4) Gustilo-Anderson grade. Statistical analysis was undertaken to identify predictors of unplanned reoperation.ResultsThe mean age of patients at the time of injury was 60.8. Unplanned reoperation rate was 17.5%. Age and Gustilo-Anderson classification grade were both statistically significant predictors of unplanned reoperation. AO-OTA classification, Sex and Diabetes were not statistically significant factors associated with unplanned reoperation.ConclusionAge and quality of soft tissue envelope are significant risk factors for unplanned reoperation. Patients with these risk factors may benefit from an alternative surgical approach. |
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