More Insights on Ankle Fracture Fixation Timing

So we conducted a retrospective course study using data from six pediatric surgeons from our organization. We identified patients who underwent ankle ORIF that was identified by the CPT code and we looked from a six year period from 2015 to 2021. So we did independent chart review and we excluded any variables that we thought might influence outcomes of soft tissue complications  besides time. So we excluded diabetes, rheumatoid arthritis, IV drug users, smokers, gout, pilon fractures, external fixation fracture blisters, open lesions, any prior surgeries in the past and we only included people from age 18 to 70 and everyone needed to have a minimum of one year follow-up. So our primary outcome of interest was surgical site infection and delayed wound healing. So we defined surgical site infection as any patients who needed antibiotics during their post-operative period or wound healing delay, meaning taking longer than four weeks to heal. In total we had 296 patients so 390 procedures recorded total. Our overall soft tissue infection rate was 4.7% and delayed wound healing rate was around 3.7%. So what we actually found was that there was no significant difference in soft tissue infection rates or wound healing time between those who had the ankle ORIF before or after seven days which was our cutoff.
 
We also found that there was no difference in wound healing rates by the different type of ankle fracture procedure whether or not it was just you know fixing a lateral mal versus a tri-mal with blister mouth fixation. But we did found that there was a significantly higher rate of infection when there were more incisions performed and the severity of ankle fracture was greater.