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Eur J Trauma Emerg Surg ; 48(4): 3157-3163, 2022 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-34989813

RESUMO

PURPOSE: Surgically treated calcaneal fractures have a high risk of postoperative wound healing complications and a prolonged length of hospital stay (LOS). The aim of this study was to identify predictor variables of impaired wound healing (IWH) and LOS in surgically treated patients with isolated calcaneal fractures. METHODS: This retrospective cohort study analyzed data on patients aged 18 years or older who were admitted to a level I trauma center with isolated calcaneal fractures between 2008 and 2018. Multivariable regression models were used to identify predictor variables. RESULTS: In total, 89 patients (age: 45.4 years; SD: 15.1) were included. In 68 of these patients, low-profile locking plate osteosynthesis was performed, and a minimally invasive approach (MIA) (percutaneous single screws/K-wire or low-profile locking plating via a sinus tarsi approach) was applied in 21 patients. Multivariable regression analysis revealed that a higher preoperative Böhler's angle (ß = - 0.16 days/degree, 95% CI [- 0.25, - 0.08], p = 0.004) and MIA (ß = - 5.04 days, 95% CI [- 8.52, - 1.56], p = 0.002) reduced the LOS. A longer time-to-surgery (ß = 1.04 days/days, 95% CI [0.66, 1.42] p = 0.001) and IWH increased the LOS (ß = 7.80 days, 95% CI [4.48, 11.12], p = 0.008). In a subsequent multivariable regression analysis, two variables, open fractures (OR: 14.6, 95% CI [1.19, 180.2], p = 0.030) and overweight (BMI > 24) (OR: 3.65, 95% CI [1.11, 12.00], p = 0.019), increased the risk of IWH. CONCLUSION: Advanced treatment algorithms for open fractures are needed to reduce the risk of IWH.


Assuntos
Traumatismos do Tornozelo , Calcâneo , Traumatismos do Pé , Fraturas Ósseas , Fraturas Expostas , Traumatismos do Joelho , Placas Ósseas , Calcâneo/lesões , Calcâneo/cirurgia , Fixação Interna de Fraturas , Fraturas Ósseas/cirurgia , Humanos , Tempo de Internação , Pessoa de Meia-Idade , Estudos Retrospectivos , Resultado do Tratamento , Cicatrização
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