What's New in Podiatry - Journal Article Summary
Early Definitive Care is as Effective as Staged Treatment Protocols for Open Ankle Fractures Caused by Rotational Mechanisms: A Retrospective Case Control Study
The current standard of practice in open fracture management has been early stabilization with delayed fixation and wound closure. However, there has been recent interest in challenging this standard and providing immediate internal fixation with primary closure. This new approach to open fracture treatment would minimize the amount of surgical interventions and length of hospital stay, but the question continues to be how that would affect the infection rate. In this study published in the new Journal of Orthopaedic Trauma, the authors looked at and compared 2 cohorts treated as previously described. They found an overall infection rate of 6.8%, without any significant difference between the 2 groups with an overall shorter length of stay, fewer number of re-operations and similar clinical outcomes for pain and radiographic findings of osteoarthritis after more than 12 months specifically for Gustilo Anderson Type I, II, and IIIa open fractures. This provides support for immediate fixation and primary closure, even in open fractures.
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