Early Versus Delayed Treatment of Severe Ankle Fractures

Konrath, Gregory A.; Karges, David E.; Watson, Jeffry T.; Moed, Berton R.; Cramer, Kathryn E.

doi:10.1097/00005131-199505000-00003

Cited by 68 publications

(59 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…3 Furthermore, a number of authors have found that delaying the open reduction and internal fixation increases the complication rate. [2][3][4][5] Importantly, in-patient stay has been shown to be significantly longer in those patients who do not get operated on within the first 24 h. 2,6 We reviewed our hospital in-patient stay for operative ankle fractures over a 12-month period. We subsequently introduced a fast-track system for fixation of these fractures and then closed the audit loop.…”

mentioning

confidence: 99%

Cost Benefit with Early Operative Fixation of Unstable Ankle Fractures

Pietzik

Qureshi

Langdon

et al. 2006

annals

View full text Add to dashboard Cite

Ann R Coll Surg Engl 2006; 88: 405-407 405The indications for ankle fracture fixation have narrowed and we no longer operate for an isolated Weber B injury.1 It has also been well documented that unless unstable fractures are fixed early, swelling or blistering may necessitate a delay in operative fixation for up to 1 week (Fig. 1).2 In practice, it is very rare for an ankle to be too swollen to undertake operative fixation on the day of admission.3 Furthermore, a number of authors have found that delaying the open reduction and internal fixation increases the complication rate.2-5 Importantly, in-patient stay has been shown to be significantly longer in those patients who do not get operated on within the first 24 h. 2,6We reviewed our hospital in-patient stay for operative ankle fractures over a 12-month period. We subsequently introduced a fast-track system for fixation of these fractures and then closed the audit loop. The aim of the current study was to compare the length of hospital stay and complication rate pre-and post-introduction of a fast-track system to treat unstable ankle fractures operatively. Patients and MethodsA retrospective review was undertaken of all ankle fractures managed by open reduction and internal fixation over a 12-month period. The fractures were classified as unimalleolar (subgroup: medial malleolus), bimalleolar or trimalleolar. We excluded all patients who failed initial nonoperative treatment and those who presented more than 24 h after injury. The patients were divided into an early operative group (< 48 h from injury) and a late operative It has been well documented that a delay in fracture fixation results in increased length of hospital stay and increased complication rate. Initial delay can also allow swelling or blistering to develop which may necessitate a further delay in operative fixation for up to 1 week. The aim of the current study was to review the length of hospital in-patient stay for operative ankle fractures over the previous 12-month period at our hospital and compare this to the length of hospital stay following the introduction of a fast-track system for the fixation of these fractures (all fractures fixed within 48 h).

show abstract

mentioning

confidence: 99%

Cost Benefit with Early Operative Fixation of Unstable Ankle Fractures

Pietzik

Qureshi

Langdon

et al. 2006

annals

View full text Add to dashboard Cite

show abstract

“…It is generally accepted that these conditions compromise early ORIF and lead to a higher incidence of local and systemic complications. Furthermore, Fogel & Morrey [8] and Konrath et al [9] showed that for ankle fractures, delayed ORIF provides similar functional results compared with immediate ORIF.…”

Section: Discussionmentioning

confidence: 99%

Temporary Kirschner Wire Ankle Transfixation and Delayed ORIF

Meier¹,

Schefold²,

Hug³

et al. 2004

Eur J Trauma

View full text Add to dashboard Cite

European Journal of TraumaAb stract Background and Purpose: Immediate ORIF (open reduction and internal fixation) is the treatment of choice for displaced ankle fractures. However, definitive treatment may have to be delayed due to compromised soft tissues. The value of temporary Kirschner wire ankle transfixation with staged ORIF for closed displaced ankle fractures with tibiotalar dislocations was determined.Patients and Methods: In this retrospective case series (1997)(1998)(1999)(2000)(2001), 92 patients (mean age 54 years, range 20-86 years) who underwent a staged procedure for isolated and closed displaced ankle fractures with tibiotalar dislocations were studied. Patients were primarily treated by means of immediate closed reduction. For stable fractures and adequate soft tissues a split plaster cast was applied (n = 50). K-wire transfixation was performed for unstable fracture-dislocations and/or critical soft tissues (n = 42). All patients underwent delayed ORIF after recovery of the soft tissues.Results: In the K-wire group (KWG), local complication rate was 7%. Mean operating time was 30 min (5-65 min). In the plaster cast group (PCG), local complication rate was 10% (p = 0.72, not significant). Three redislocated ankles (6%) had to be transfixed secondarily. A higher grade of soft-tissue injuries in the KWG (p < 0.05) resulted in a longer time interval between primary treatment and staged ORIF (7 vs. 5 days; p < 0.05) and a longer hospital stay (19 vs. 17 days; p < 0.05) for the KWG.Conclusion: Temporary K-wire ankle transfixation is an effective method for initial treatment of closed displaced ankle fractures with tibiotalar dislocation, if ORIF has to be delayed and immobilization in a split plaster cast is not suitable. Retention is reliable with a low complication rate.

show abstract

“…Comparing the results of early vs. delayed treatment of ankle fractures, it has been shown that delayed treatment was equivocal in wound complications and the patients had a shorter hospital stay. That study excluded any fracture requiring syndesmotic fixation and therefore would have excluded most if not all Bosworth fracture-dislocations [13]. Posttraumatic adhesive capsulitis was a complication of the ankle with patients who had failed closed reduction with surgery occurring 2-4 days after injury.…”

Section: Discussionmentioning

confidence: 99%

Rare Ankle Fracture Pattern: Bosworth Fracture can Lead to Post-Traumatic Arthritis if Unrecognized Early

Hancock¹

2015

MOJOR

View full text Add to dashboard Cite

Early Versus Delayed Treatment of Severe Ankle Fractures

Cited by 68 publications

References 0 publications

Cost Benefit with Early Operative Fixation of Unstable Ankle Fractures

Cost Benefit with Early Operative Fixation of Unstable Ankle Fractures

Temporary Kirschner Wire Ankle Transfixation and Delayed ORIF

Rare Ankle Fracture Pattern: Bosworth Fracture can Lead to Post-Traumatic Arthritis if Unrecognized Early

Contact Info

Product

Resources

About