The injury characteristics of open pilon fractures predictive of complications.
Injury
; 53(4): 1510-1516, 2022 Apr.
Article
in En
| MEDLINE
| ID: mdl-35067342
ABSTRACT
OBJECTIVE:
Determine predictive injury factors for wound complications in open pilon fractures (OTA/AO 43B and 43C).DESIGN:
Retrospective Case Series.SETTING:
Level I Trauma Center. PATIENTS/PARTICIPANTS:
A total of 61 open pilon fractures in 60 patients were evaluated after meeting inclusion and exclusion criteria. INTERVENTION The majority of injuries underwent a staged protocol with immediate antibiotics, debridement, irrigation and external fixation. Following soft tissue stabilization, internal fixation was performed and wound closure achieved in a coordinated fashion depending on the type of closure required. MAIN OUTCOME MEASUREMENTS Early amputation rate, 90-day major (wound dehiscence or deep infection requiring operative intervention) and minor (superficial infection) wound complications.RESULTS:
Four patients incurred early amputations, 11 had major wound complications and 5 had minor wound complications. An early amputation was more likely if they presented with an OTA Open Fracture Classification (OTA-OFC) Bone Loss Grade 3. A major wound complication was more likely if they presented with a fall from > 3 m, a multifragmentary articular surface, a segmental fibula fracture, or an OTA-OFC Contamination Grade 3. A multifragmentary articular surface was also predictive of developing any wound complication.CONCLUSIONS:
Open pilon fractures are severe, limb-threatening injuries and are at risk for wound complications. Patients presenting with these injuries and a predictive factor should be counseled regarding the possibility of early limb loss or experiencing a wound complication that will require additional treatment. LEVEL OF EVIDENCE Level III.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Tibial Fractures
/
Ankle Fractures
/
Fractures, Open
Type of study:
Etiology_studies
/
Guideline
/
Observational_studies
/
Prognostic_studies
Limits:
Humans
Language:
En
Journal:
Injury
Year:
2022
Document type:
Article
Affiliation country:
United States