Preoperative Risk Score for Predicting Delayed Wound Healing After Plate Fixation in Patients With Closed Distal...

Area of Science:

• Orthopedic surgery
• Wound healing research
• Biostatistics

Background:

• Delayed wound healing after open reduction and internal fixation (ORIF) for distal fibular fractures poses risks to patient recovery and increases infection rates.
• Effective prediction of wound healing complications is crucial for optimizing patient outcomes in orthopedic trauma care.

Purpose of the Study:

• To develop a straightforward preoperative scoring system to predict delayed wound healing in patients undergoing plate fixation for closed distal fibular fractures.

Main Methods:

• A retrospective cohort study analyzed 84 patients with closed distal fibular fractures treated with plate fixation.
• Preoperative variables including age, diabetes, fracture complexity, and planned plate number were collected and analyzed using logistic regression to create a weighted risk score.
• Delayed wound healing was defined using the Southampton Wound Assessment Scale (Grade 2 or higher).

Main Results:

• Delayed wound healing was observed in 30 patients.
• Independent predictors identified were age ≥70 years, complex fracture type, and the use of ≥2 plates, with diabetes mellitus also retained.
• A scoring system was developed: age and diabetes (1 point each), fracture type and ≥2 plates (2 points each), demonstrating good predictive performance.

Conclusions:

• A simple, four-variable preoperative scoring system was successfully developed to predict delayed wound healing after ORIF for closed distal fibular fractures.
• This tool facilitates early risk stratification, enabling informed surgical planning and personalized perioperative care to mitigate wound complications.