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Inpatient soft tissue protocol and wound complications in calcaneus fractures
Patrick F Bergin1, Telly Psaradellis, Michael T Krosin
1OrthoIndy, Indianapolis, IN 46202, USA.
Foot & Ankle International
|June 28, 2012
Summary
Aggressively managing soft tissues in the hospital for calcaneus fractures allows for earlier surgery and fewer wound complications. This inpatient approach to calcaneal fracture treatment is effective and feasible.
Area of Science:
- Orthopedic surgery
- Trauma care
- Soft tissue management
Background:
- Operative treatment of calcaneus fractures carries a risk of early wound complications.
- Current practice often delays surgery until soft tissues recover, but optimal timing remains unclear.
Purpose of the Study:
- To evaluate an aggressive inpatient soft tissue management protocol for calcaneus fractures.
- To determine if this protocol reduces complications and allows for earlier surgical intervention.
Main Methods:
- Retrospective review of 102 calcaneus fractures (97 patients) treated between 1995 and 2005.
- Comparison of complication rates and quality of reduction between inpatient and outpatient treatment groups.
- Analysis of postoperative Bohler's angle and posterior facet articular step-off.
Main Results:
- Inpatient group surgery occurred a mean of 4.6 days earlier (6.2 vs. 10.8 days).
- Overall complication rate was lower in the inpatient group (12% vs. 27%).
- Serious complication rate was significantly higher in the outpatient group (9% vs. 1%).
Conclusions:
- An aggressive inpatient soft tissue management protocol for calcaneus fractures is feasible.
- This protocol reduces postoperative wound complications.
- It enables earlier surgical intervention without compromising the quality of fracture reduction.
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