Open surgical management of high energy ipsilateral fractures of the fibula and calcaneus

Scolaro, John A.; Roberts, Zachary V.; Benirschke, Stephen K.; Barei, David P.

doi:10.1016/j.fas.2014.11.006

Cited by 3 publications

(4 citation statements)

References 27 publications

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“…The second incision is tolerated well if incisional placement and soft tissue handling are appropriate. 5 We have not noted associated wound healing issues with the second incision.…”

Section: Peroneal Tendon Instability In Calcaneus Fractures: a Commen...mentioning

confidence: 76%

Peroneal Tendon Instability in Calcaneus Fractures: A Commentary

Ciufo,

Ketz

2023

Foot Ankle Int.

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“…The second incision is tolerated well if incisional placement and soft tissue handling are appropriate. 5 We have not noted associated wound healing issues with the second incision.…”

Section: Peroneal Tendon Instability In Calcaneus Fractures: a Commen...mentioning

confidence: 76%

Peroneal Tendon Instability in Calcaneus Fractures: A Commentary

Ciufo,

Ketz

2023

Foot Ankle Int.

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“…This is especially true in high‐energy calcaneal fractures, where a compromised soft tissue envelope with extensive oedema, fracture blisters, and ecchymosis may be present. 39 , 40 Many surgeons performed surgery after detumescence of the injured foot and suggested that it is critical to avoid soft‐tissue complications. Generally, calcaneal fractures are caused by high‐energy impacts, and the relatively thin coverage of soft tissue on the heel also suffers severe injury.…”

Section: Discussionmentioning

confidence: 99%

“…It is vitally important for the surgeon to delay surgery until the swelling subsides sufficiently, since wound edge necrosis, skin slough, and postoperative infections can be the consequence of a prematurely performed ORIF. This is especially true in high‐energy calcaneal fractures, where a compromised soft tissue envelope with extensive oedema, fracture blisters, and ecchymosis may be present 39,40 . Many surgeons performed surgery after detumescence of the injured foot and suggested that it is critical to avoid soft‐tissue complications.…”

Section: Discussionmentioning

confidence: 99%

A nomogram for predicting post‐operative wound complications after open reduction and internal fixation for calcaneal fractures

Huang

Zhang

et al. 2022

International Wound Journal

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The purpose of our study was to determine the risk factors for post-operative wound complications (PWCs) after open reduction and internal fixation (ORIF) for calcaneal fracture and establish a nomogram prediction model. We retrospectively analysed the clinical data of patients who suffered from calcaneal fractures and had been surgically treated for ORIF in our institution between January 2010 and January 2020. Perioperative information was obtained through the electronic medical record system, univariate and multivariate analyses were performed to determine the risk factors of PWCs, and a nomogram model was constructed to predict the risk of PWCs. The predictive performance and consistency of the model were evaluated by the Hosmer -Lemeshow (H-L) test and the calibration curve. In total, 444 patients were enrolled in our study. Multivariate analysis results showed that smoking, limb swelling, angle of incision, and CRP were independent risk factors for skin necrosis. The AUC value for skin necrosis risk was 0.982 (95%CI 0.97-0.99).The H-L test revealed that the normogram prediction model had good calibration ability (P = .957). Finally, we found a correlation between PWCs and smoking, limb swelling, angle of incision, and CRP after ORIF for calcaneal fracture patients. Our nomogram prediction model might be helpful for clinicians to identify high-risk patients, as interventions could be taken early to reduce the incidence of PWCs.

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“…7 Specifically, the thin skin coverage over the medial and lateral malleoli may predispose patients to postoperative wound complications, such as superficial infections and skin necrosis. [8][9][10] The incidence of such wound complications ranges from 1.4% to 18.8% in the literature. 7 Several studies have examined the risk factors associated with wound complications following rotational ankle fracture surgery.…”

mentioning

confidence: 99%

Wound-Healing Issues Following Rotational Ankle Fracture Surgery: Predictors and Local Management Options

Saleh

Konda

Driesman

et al. 2018

Foot & Ankle Specialist

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Background. The incidence and risk factors of wound-healing complications following rotational ankle fracture surgery are well documented in the literature. However, there is a paucity regarding management options following these complications. The goal of this study was to provide a descriptive analysis of one surgeon’s experience managing wound complications in patients who have undergone ankle fracture surgery. Methods. A total of 215 patients who were operatively treated for an unstable ankle were retrospectively identified. Patient demographics, medical histories, initial injury characteristics, surgical interventions, and clinical follow-up were collected. Twenty-five of these patients developed postoperative wound problems. Results. Of the original cohort of 215 patients, 25 (11.6%) developed wound-healing complications. Their average age was 53.6 ± 18.0 years; there were 12 males (48.0%). Connective tissue/inflammatory disease (odds ratio [OR] 3.9), cardiovascular disease (OR 3.6), and active smoking (OR 3.3) were associated with an increased likelihood of developing postoperative wound complications. With regard to injuries, open fractures (OR 17.9) had the highest likelihood of developing postoperative complications, followed by type 44-C (OR 2.8) and trimalleolar fractures (OR 2.0). Conclusion. Wound complications following open treatment of ankle fractures occurred with an incidence of 11.6% in this series, of which only about half required operative intervention. A third of wounds were managed by orthopaedics in conjunction with plastic surgery. Levels of Evidence: Level III: Retrospective comparative study

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Open surgical management of high energy ipsilateral fractures of the fibula and calcaneus

Cited by 3 publications

References 27 publications

Peroneal Tendon Instability in Calcaneus Fractures: A Commentary

Peroneal Tendon Instability in Calcaneus Fractures: A Commentary

A nomogram for predicting post‐operative wound complications after open reduction and internal fixation for calcaneal fractures

Wound-Healing Issues Following Rotational Ankle Fracture Surgery: Predictors and Local Management Options

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