Surgical Site Complications in Open Pronation-Abduction Ankle Fracture-Dislocations With Medial Tension Failure Wounds

Case W. Martin, James C. Ryan, Travis S. Bullock, John H. Cabot, Ahmed A. Makhani, Leah P. Griffin, Boris A. Zelle

Research output: Contribution to journalArticlepeer-review

Abstract

Objectives: To examine the incidence of surgical site complications associated with pronation-abduction ankle fracture-dislocations with an open medial tension wound. Design: Retrospective case series. Setting: Accredited Level-1 trauma center. Patients/Participants: Forty-eight open pronation-abduction ankle fracture-dislocations with medial tension failure wounds treated at our institution from 2014 to 2016. Intervention: Immediate irrigation and debridement along with surgical stabilization of open ankle fracture-dislocation. Main Outcome Measures: The primary outcome measure was deep surgical site infection. Secondary outcome measures included other surgical site complications and adverse radiographic events. Results: A total of 5 patients (10.4%) developed a deep surgical site infection requiring additional surgical debridement. One of the patients with a deep surgical site infection required a below-knee amputation as a result of sepsis. Adverse radiographic outcomes included 3 fibular nonunions (6.3%), 3 implant failures related to syndesmotic fixations (6.3%), one periimplant fracture (2.1%), and postoperative collapse of the tibial plafond in 3 patients (6.3%). Conclusions: Open pronation-abduction ankle fracture-dislocations with medial tension failure wounds remain a challenging and potentially devastating injury. Our study suggests that with appropriate surgical debridement, early stabilization, and primary wound closure, acceptable outcomes with a relatively low risk of surgical site complications can be achieved.

Original languageEnglish (US)
Pages (from-to)E481-E485
JournalJournal of orthopaedic trauma
Volume35
Issue number12
DOIs
StatePublished - Dec 1 2021

Keywords

  • Ankle fractures
  • Open fracture
  • Outcome
  • Surgical site infection

ASJC Scopus subject areas

  • Surgery
  • Orthopedics and Sports Medicine

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