A Scoping Review on the Management of Open Fractures in African Trauma and Orthopaedics Centres.

Journal and index pages often block iframe embedding. This reader keeps the evidence details in Orthonotes and leaves the source page one click away.

Abstract

Conflict of interest statement: Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work. 20. J Foot Ankle Surg. 2024 Nov-Dec;63(6):631-636. doi: 10.1053/j.jfas.2024.06.001. Epub 2024 Jun 22. Open Ankle Fractures in Older Individuals: A Multi-center Study. Nathe K(1), Bakaes Y(2), Giakas AM(3), Kung J(1), Gauthier C(1), Grabowski G(1), Smoker B(4), Boguski J(5), Toole W(6), Elliott M(6), Van Eck CF(7), Bowman E(8), Townsend C(9), Jackson JB(1). Author information: (1)Prisma Health Midlands Department of Orthopaedic Surgery, Columbia, SC. (2)University of South Carolina School of Medicine Columbia, Columbia, SC. Electronic address: ybakaes15@gmail.com. (3)Department of Orthopaedic Surgery, Rothman Orthopaedic Institute at Thomas Jefferson University, Philadelphia, PA. (4)University of South Carolina School of Medicine Columbia, Columbia, SC. (5)Lexington Medical Center, West Columbia, SC. (6)University of Florida College of Medicine, Jacksonville, FL. (7)University of Pittsburg Medical Center, Pittsburgh, PA. (8)University of Nebraska Medical Center, Omaha, NE. (9)Prisma Health Upstate Department of Orthopaedic Surgery, Greenville, SC. The purpose of this study is to identify demographics, etiology, comorbidities, treatment, complications, and outcomes for older patients with open ankle fractures. Patients ≥60 years old who sustained an open ankle fracture between January 1, 2004 and March 31, 2014 at 6 Level 1 trauma centers were retrospectively reviewed. Univariate analysis using chi-squared or Student's t test was performed to identify associations between preoperative variables and 2 postoperative outcomes of interest: amputation and 1-year mortality. Multivariate analysis was performed using stepwise logistical regression to identify independent predictors of postoperative amputation and 1-year mortality. Of the 162 total patients, the most common mechanism of injury was a ground-level fall (51.9%). The most common fracture types were bimalleolar fractures (52.5%) followed by trimalleolar fractures (26.5%), with 41.5% of the fractures classified as Gustilo Anderson Classification Type 2 and 38.6% classified as Type 3A. The average number of surgeries required per patient was 2.1. Complications included: 15.4% superficial infection rate, 9.9% deep infection rate, and 9.3% amputation rate. The 1-year mortality rate was 13.6% and the overall mortality rate was 25.9%. Male gender and fracture type were found to be independent predictors for amputation after surgery (p = .009, .005, respectively). Older age and having diabetes were independent predictors for 1-year mortality after surgery (p = .021, .005 respectively). Overall, open ankle fractures in older individuals were associated with high rates of amputation and mortality. Copyright © 2024 the American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved. DOI: 10.1053/j.jfas.2024.06.001