Close suction drainage systems are widely used in orthopedics and spine surgeries. There are less studies investigating the outcomes of using subfascial closed suction drains in adolescent patients who had undergone idiopathic scoliosis surgery. We evaluated the outcomes of patients with and without closed suction drainage and to investigate whether close suction drainage is needed after adolescent idiopathic scoliosis (AIS) surgery. We retrospectively investigated 63 patients, who underwent posterior spinal surgery for AIS from January 2015 to January 2018. The patients were divided into the following groups: Groups A (drainage group) and B (nondrainage group). We evaluated the wound drainage (wound oozing), need for transfusion, preoperative and postoperative hemoglobin levels, length of hospital stay, and postoperative blood loss from closed suction drains. Patients’ scoliosis was categorized according to the Lenke Classification System for Scoliosis. The level of instrumentations was also evaluated. The median postoperative hemoglobin level was lower in group A than in group B. Postoperatively, group A underwent more blood transfusions than group B. Postoperative hospital stay was also significantly longer in group A than in group B. There was no statistical difference in the infection rate between the two groups. Using drains after AIS surgery increases hospital stay duration, blood transfusion rate and patients’ anxiety of drain tube removal. Thus, closed suction drainage may not be suitable after AIS surgery.

We report the outcomes of mechanical prophylaxis and chemoprophylaxis in patients who underwent elective surgery for idiopathic adolescent scoliosis (AIS). We retrospectively studied the patients who underwent posterior spinal instrumentation for AIS. The patients were divided into three groups: Group A low-molecular-weight heparin (LMWH) started at 8 hours after surgery; Group B LMWH started at 24 hr after surgery; Group C did not receive chemoprophylaxis. The data about wound oozing, need for transfusion, preoperative and postoperative hemoglobin level, length of stay in hospital, interval from the surgery to removal of closed suction drainage tube, postoperative blood loss from closed suction drain, deep venous thrombosis (DVT), and pulmonary embolism (PE) were investigated. The mean age and Lenke classification for all the groups were similar. No DVT or PE was detected in any group. The mean blood loss from the drain was higher in Group A (400 mL) and Group B (450 mL) when compared to Group C (150 mL) ( P = .001). There were more wound oozing in Groups A (5) and B (6) than in Group C (3) ( P = .585). Three patients in Group B, 3 patients in Group A, and no patient in Group C had superficial infections. However, there was no statistical difference between the groups ( P = .182). Postoperative hospital stay was significantly longer in Groups A (6 days) and B (6 days) then in Group C (5 days) ( P = .001). Our current study claims that chemoprophylaxis is not necessary for the patients without risk factors after AIS surgery. Early mobilization and mechanoprophylaxis represents adequate prophylaxis in addition to pain management and well hydration in patients’ routine treatment. The complications of chemoprophylaxis are not correlated to the initiation time of prophylaxis.

Scoring systems and the ischemic time are not the only predictors of amputation. The decision of the treatment mode should be made by the patient and the care team after discussing the options and outcomes rather than relying on a scoring system.

Background: The present study evaluated the functional and radiographic outcomes of acute acromioclavicular (AC) joint reconstruction performed using the mini-open technique and a knotless suspensory loop device Methods: A total of 25 patients (20 male and 5 female patients; mean age, 30.7 years; standard deviation, 10 years; range, 17–57 years) who fulfilled the inclusion criteria were included in the study. A functional assessment was performed using the Constant and University of California Los Angeles score. The radiologic assessment included standard anterior-posterior views of the AC and coracoclavicular (CC) distances. Results: The mean follow-up period was 18.6 months (range, 12–23 months). The mean Constant score was 87.2 ± 3.2, and the mean University of California Los Angeles score was 30.1 ± 2.4 at the final follow-up. Radiological evaluation at the last follow-up of the patients: Although there was no statistically significant increase in the AC and CC values of the patients (Fig. 2 ) at the last follow-up, the average CC value in 6 (24%) of the 25 patients was greater than 50% compared with the unaffected side CC and early postoperative CC values. However, there was no statistically significant difference in the Constant and UCLA scores between the 6 patients with reduction loss and the 19 patients with reduction maintenance ( P = .86). Conclusions: Clinical results of fixation of acute AC joint dislocations using the ZipTight TM knotless suspensory loop device system and mini-open technique were favorable in terms of functional recovery and pain relief. However, the major disadvantage of this method was radiological loss of AC joint reduction when compared to the contralateral shoulder.