Experience With Immediate Internal Fixation Combined With Primary Wound Closure in Gustilo-Anderson Type IIIA Open...

Area of Science:

• Orthopedic Surgery
• Trauma Management
• Reconstructive Surgery

Background:

• Gustilo-Anderson type IIIA open ankle fractures present significant management challenges.
• Optimal treatment strategies remain debated, impacting patient outcomes.
• Early intervention is crucial for minimizing complications and restoring function.

Purpose of the Study:

• To evaluate the efficacy of immediate internal fixation combined with primary wound closure.
• To assess functional outcomes and complication rates in Gustilo-Anderson type IIIA open ankle fractures.
• To provide evidence for optimal surgical management of these severe injuries.

Main Methods:

• Retrospective analysis of 32 patients with Gustilo-Anderson type IIIA open ankle fractures.
• Treatment involved immediate internal fixation and primary wound closure.
• Minimum follow-up of 24 months, with a median of 38 months.

Main Results:

• High functional outcomes: 90.6% excellent/good results per American Orthopaedic Foot and Ankle Society (AOFAS) scale.
• Mean AOFAS score of 87.22 ± 4.05.
• Low complication rates: 6.4% infection, 15.6% skin necrosis, 3.2% arthritis, 3.2% reoperation.

Conclusions:

• Immediate internal fixation with primary wound closure is a viable and effective strategy for Gustilo-Anderson type IIIA open ankle fractures.
• This approach achieves favorable functional outcomes and minimizes complications.
• Supports the use of early surgical stabilization and wound management in severe open ankle injuries.