Blisters in Ankle Fractures: A Retrospective Cohort Study.

The most frequent postoperative complications after an ankle fracture are usually skin related. We present the results of a retrospective study of 112 patients with ankle fracture who had undergone open reduction and internal fixation from January 2014 to December 2014. The following features were analyzed: patient comorbidities, fracture type, the presence of an open fracture or fracture-dislocation, timing and duration of surgery, preoperative glucose level, and short-term complications (i.e., blisters, wound dehiscence, deep and superficial infections, and reintervention). The mean age of the patients was 50.38 years. Fracture blisters were present in 20.5% of the cases. The operative time was 75.74 ± 25.09 minutes for patients with blisters and 64.48 ± 19.73 minutes for patients without blisters (p = .023). The preoperative blood glucose levels were 122.96 ± 28.46 g/dL in the patients with blisters and 106.70 ± 21.32 g/dL in the patients without blisters (p = .003). No statistically significant differences were observed between the patients who had undergone surgery <24 hours after injury and those who had done so >24 hours after injury. In conclusion, the presence of postoperative blisters in patients with ankle fractures was associated with prolonged surgical procedures and high serum glucose levels.

Radiologic and Functional Outcomes in Unstable Thoracolumbar Fractures Treated With Short-segment Pedicle Instrumentation.

STUDY DESIGN: A retrospective review of radiographs, clinical charts, and health questionnaires of 40 patients. OBJECTIVE: To evaluate the radiologic and functional results of unstable thoracolumbar fractures treated with short-segment pedicle instrumentation (SSPI). A SUMMARY OF BACKGROUND DATA: Although earlier publications report a risk of correction loss or material failure after short-segment fixation in unstable thoracolumbar fractures, more current data suggest that improvements in this technique could offer good clinical and radiologic results. MATERIALS AND METHODS: We undertook a retrospective review of 40 patients with unstable thoracolumbar fractures treated with SSPI. Radiographs and computed tomogrphic scans were analyzed to determine fracture classification and sagittal plane deformity, estimated by the Cobb method. The rates of final kyphosis and correction loss and their relationship with the Load Sharing Classification (LSC) and the AO classification were analyzed. We reviewed the hospital charts to identify complications and outcomes. At the final follow-up, the Short-Form 36 health survey was carried out to evaluate the functional outcome. The relationship between conditions such as polytrauma, neurological compromise or fracture site, and radiological and functional outcomes was also analyzed. RESULTS: We observed mean values of 5.9 degrees of final follow-up kyphosis and 5.1 degrees of correction loss. One case of material failure was seen. The severity in the LSC or the AO classification, polytrauma, neurological compromise, or fracture site had no relationship with worse radiologic or functional outcomes. CONCLUSIONS: SSPI shows good results in fracture reduction, with good functional outcomes despite the loss of correction seen at the final follow-up. Although no investigated variable was found to be predictive of radiographic failure, a trend was identified (P=0.07) that patients with a higher LSC had an increased loss of correction.

Resultados de la reparación quirúrgica de las roturas agudas del tendón distal del bíceps braquial a medio plazo: influencia de la vía de abordaje quirúrgica / Mid-term results of surgical repair of distal biceps rupture: influence of surgical approach

Objetivo: Describir los resultados funcionales y las complicaciones a medio plazo de la reparación quirúrgica de la avulsión del tendón distal del bíceps braquial y establecer una relación con la vía de abordaje empleada. Métodos: 17 pacientes consecutivos fueron intervenidos. Se registró la vía de abordaje empleada. Se recogieron los valores postoperatorios de rango de movilidad articular, capacidad funcional medido como puntuación del cuestionario Quick - DASH score y se registraron las complicaciones. Resultados: En 14 pacientes se reparó el tendón distal del bíceps. En 3 se confirmó su integridad. En 3 casos se empleó una vía anterior y en 11 una doble vía. Flexión media: 131'43º; extensión: - 3'21º pronación: 70'71º; supinación: 74’29º; puntuación Quick - DASH score: 17'04. Seguimiento: 25'5 meses. Aparecieron complicaciones en el 57’14%. La más frecuente fueron las parestesias locales, con resolución espontánea en todos los casos. Los pacientes intervenidos por doble vía obtuvieron resultados mejores en comparación con los intervenidos por vía única. Conclusiones: La reparación quirúrgica de las roturas agudas del tendón distal del bíceps braquial presenta aceptables resultados postoperatorios con una alta tasa de complicaciones, si bien estas últimas son en su mayoría de escasa relevancia. Estos resultados mejoran cuando se emplea la técnica de doble vía descrita por Boyd Anderson y modificada por Morrey

Purpose: Describe mid-term functional results and complications rate after surgical reattachment of acute distal biceps tendon ruptures and relate them with the surgical approach employed. Methods: 17 consecutive patients were evaluated. Surgical approach employed was registered, as well as post-operative range of motion of the elbow, physical function measured as Quick - DASH Score and complications. Results: Complete rupture of biceps tendon was observed in 14 cases during surgery. The anterior approach was used in 3, the double incision technique was used in 11. Average flexion: 131'43º; extension: -3'21º; pronation: 70'71º; supination: 74'29º; Quick - DASH Score: 17'04. Average follow - up: 25'5 months. Complication rate was 57'14%. The more frequent complications were local paresthesias which were solved spontaneously in all cases. The double incision technique group of patients had overall better results compared to the anterior approach group. Conclusions: Reattachment of acute distal biceps tendon ruptures shows acceptable postoperative results and high complications rate with low clinical relevance. These results seem to be better when the Boyd - Anderson double incision technique modified by Morrey is employed