Minimally Invasive Plate Osteosynthesis for Treatment of Ankle Fractures in High-Risk Patients

Bazarov, Irina; Kim, Jason; Richey, Johanna Marie; Dickinson, Joseph D.; Hamilton, Graham A.

doi:10.1053/j.jfas.2017.11.004

Cited by 9 publications

(2 citation statements)

References 42 publications

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“…Minimally invasive plate osteosynthesis (MIPO) has been applied in fractures where spanning larger distances are required. Bazarov et al reported on 44 patients who underwent MIPO fixation for unstable ankle fractures, 23 of whom had diabetes (Level IV evidence) 58 . They reported excellent quality of reduction in 30/44 patients (68%), 25% had wound dehiscence, 1 developed superficial infection, and 3 developed deep infections requiring return to operating room (OR).…”

Section: Minimally Invasive Plate Osteosynthesismentioning

confidence: 99%

Ankle Fractures in Diabetic Patients

2023

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Patients with diabetes are at higher risk for complications after surgical fixation of unstable fractures due to impaired neurovascular functioning and wound-healing capabilities.Patients with uncontrolled diabetes have higher rates of complications when compared with patients with controlled diabetes.Despite higher rates of complications, operative fixation of unstable ankle fractures in diabetic patients reliably leads to a functional lower extremity with an overall lower rate of complications than nonoperative management.Operatively and nonoperatively managed ankle fractures in patients with diabetes should remain non–weight-bearing for an extended period of time.Discussion of risk of poor outcomes including deep infection, loss of reduction, return to the operating room, and risk of arthrodesis or amputation should be explicitly discussed with patients and families when managing unstable ankle fractures in diabetic patients.

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Section: Minimally Invasive Plate Osteosynthesismentioning

confidence: 99%

Ankle Fractures in Diabetic Patients

2023

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“…Potential risk factors can be patient-related, injury-related and treatment-related [11,12,[14][15][16][17]. Patient-related factors include age at operation, diabetes mellitus, peripheral artery disease (PAD), or smoking [7,[18][19][20]. Injury related risk factors may be open fractures and dislocation fractures [21].…”

Section: Introductionmentioning

confidence: 99%

Risk Factors for Fracture-Related Infection After Ankle Fracture Surgery

Pilskog,

Høvding,

Fenstad

et al. 2023

Bone Joint J

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AimAnkle fracture surgery comes with a risk of fracture-related infection (FRI). Identifying risk factors are important in preoperative planning, in management of patients, and for information to the individual patient about their risk of complications. In addition, modifiable factors can be addressed prior to surgery. The aim of the current paper was to identify risk factors for FRI in patients operated for ankle fractures.MethodA cohort of 1004 patients surgically treated for ankle fractures at Haukeland University hospital in the period of 2015–2019 was studied retrospectively. Patient charts and radiographs were assessed for the diagnosis of FRI. Binary logistic regression was used in analyses of risk factors. Regression coefficients were used to calculate the probability for FRI based on the patients’ age and presence of one or more risk factors.ResultsFRI was confirmed in 87 (9%) of 1004 patients. Higher age at operation (p < 0.001), congestive heart failure (CHF), p = 0.006), peripheral artery disease (PAD, p = 0.001), and current smoking (p = .006) were identified as risk factors for FRI. PAD and CHF were the risk factors displaying the strongest association with FRI with an adjusted odds ratio of 4.2 (95% CI 1.8–10.1) and 4.7 (95% CI 1.6–14.1) respectively.ConclusionsThe prevalence of FRI was 9% after surgical treatment of ankle fractures. The combination of risk factors found in this study demonstrate the need for a thorough, multidisciplinary, and careful approach when faced with an elderly or frail patient with an ankle fracture. The results of this study help the treating surgeons to inform their patients of the risk of FRI prior to ankle fracture surgery.

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