BACKGROUND:
Ankle fracture fixation is one of the most commonly performed
orthopaedic procedures. Although the results are generally favourable, complications are not uncommon, particularly in the case of
surgical site
infections. These have considerable impact on both postoperative
morbidity and healthcare costs. Paradoxically, there is a paucity of literature studying patients who
sustain them and therefore little is known about ways such occurrences can be minimised. The purpose of this study was to determine the
infection rate following
ankle fracture fixation and elucidate variables in their causation. METHODS: We retrospectively reviewed 50 consecutive patients who underwent open reduction and internal fixation of an
ankle fracture. The study group consisted of 26 females and 24 males with an
average age of 43 (Range 16-82) years. RESULTS: Problems with superficial
infections were noted in seven patients and deep
infections in five. Of the latter, four patients underwent further
surgery including two that had their
metal work removed. With use of the
Fisher's exact test we determined that only
smoking and a bimalleolar fracture pattern were significant variables, having p-values of 0.02 and 0.04 respectively. CONCLUSION: We recommend that patients with
ankle fractures who either have a history of
smoking and/or bimalleolar
injury be counselled about the potential risk of
infection and its implications on their functional recovery. The ability to identify patients at risk of such problems highlights the need for caution during the perioperative period so that care strategies may be altered to facilitate recovery.
