PURPOSE: The present study aimed to determine the most common surgical errors resulting in early re-operation following ankle fracture surgery. METHODS: We performed a chart review to determine the most common types of malreductions that led to early re-operation following ankle fracture surgery. From 2002 to 2011, we identified 5,123 consecutive ankle fracture operations in 5,071 patients. Seventy-nine patients (1.6%) which underwent re-operation due to malreduction detected in postoperative radiographs. These patients were compared with an equal number of age- and sex-matched controls which did not need further surgery. RESULTS: The most common indication for re-operation was syndesmotic malreduction (47 of 79 patients, 59%). Four main types of errors related to syndesmotic reduction or fixation were identified, with the most common being fibular malpositioning within the tibiofibular incisura. Other indications for re-operation were fibular shortening and malreduction of the medial malleolus. Fracture dislocation, fracture type, posterior malleolar fracture, associated medial malleolar fracture, duration of index surgery, and fixation of an associated medial malleolar fracture with other than two parallel screws were also associated with re-operation. Correction of the malreduction was successfully achieved in the majority (84%) of cases needing further surgery. CONCLUSION: Early re-operation after ankle fracture surgery was most commonly caused by errors related to syndesmotic reduction or failure to restore fibular length. In the majority of cases, postoperative malreduction was successfully corrected in the acute setting.
PURPOSE: The present study aimed to determine the most common surgical errors resulting in early re-operation following ankle fracture surgery. METHODS: We performed a chart review to determine the most common types of malreductions that led to early re-operation following ankle fracture surgery. From 2002 to 2011, we identified 5,123 consecutive ankle fracture operations in 5,071 patients. Seventy-nine patients (1.6%) which underwent re-operation due to malreduction detected in postoperative radiographs. These patients were compared with an equal number of age- and sex-matched controls which did not need further surgery. RESULTS: The most common indication for re-operation was syndesmotic malreduction (47 of 79 patients, 59%). Four main types of errors related to syndesmotic reduction or fixation were identified, with the most common being fibular malpositioning within the tibiofibular incisura. Other indications for re-operation were fibular shortening and malreduction of the medial malleolus. Fracture dislocation, fracture type, posterior malleolar fracture, associated medial malleolar fracture, duration of index surgery, and fixation of an associated medial malleolar fracture with other than two parallel screws were also associated with re-operation. Correction of the malreduction was successfully achieved in the majority (84%) of cases needing further surgery. CONCLUSION: Early re-operation after ankle fracture surgery was most commonly caused by errors related to syndesmotic reduction or failure to restore fibular length. In the majority of cases, postoperative malreduction was successfully corrected in the acute setting.
Authors: Attila Vasarhelyi; Jessica Lubitz; Philip Gierer; Georg Gradl; Klaus Rösler; Werner Hopfenmüller; Kaj Klaue; Thomas W F Mittlmeier Journal: Foot Ankle Int Date: 2006-12 Impact factor: 2.827
Authors: Anne Lübbeke; Davide Salvo; Richard Stern; Pierre Hoffmeyer; Nicolas Holzer; Mathieu Assal Journal: Int Orthop Date: 2012-01-17 Impact factor: 3.075
Authors: Michael J Gardner; Demetris Demetrakopoulos; Stephen M Briggs; David L Helfet; Dean G Lorich Journal: Foot Ankle Int Date: 2006-10 Impact factor: 2.827
Authors: Bernhard Kessler; Parham Sendi; Peter Graber; Markus Knupp; Lukas Zwicky; Beat Hintermann; Werner Zimmerli Journal: J Bone Joint Surg Am Date: 2012-10-17 Impact factor: 5.284
Authors: Remco J A van Wensen; Michel P J van den Bekerom; René K Marti; Ronald J van Heerwaarden Journal: Strategies Trauma Limb Reconstr Date: 2011-04-06