Soft tissue complications and timing of surgery in patients with a tongue-type displaced intra-articular calcaneal fracture: An international retrospective cohort study
| Autor: | Dennis den Hartog, Michael H.J. Verhofstad, Tim Schepers, Dominique Misselyn, A. Siebe De Boer, Esther M.M. Van Lieshout, Freek R. van ’t Land |
|---|---|
| Přispěvatelé: | AMS - Restoration & Development, Surgery |
| Rok vydání: | 2017 |
| Předmět: |
Adult
Male medicine.medical_specialty Heel Soft Tissue Injuries Time Factors Intra-Articular Fractures Risk Assessment 03 medical and health sciences Fracture Fixation Internal 0302 clinical medicine Calcaneal fracture Tongue medicine Humans Ankle Injuries Depression (differential diagnoses) General Environmental Science Retrospective Studies 030222 orthopedics Wound Healing business.industry Soft tissue 030208 emergency & critical care medicine Retrospective cohort study Middle Aged medicine.disease Surgery Calcaneus medicine.anatomical_structure Treatment Outcome General Earth and Planetary Sciences Female Complication business |
| Zdroj: | Injury, 49(2), 425-429. Elsevier Limited Injury, 49(2), 425-429. Elsevier Ltd. |
| ISSN: | 1879-0267 0020-1383 |
| Popis: | Tongue-type displaced intra-articular calcaneal fractures (DIACF) are associated with a specific pattern of fracture displacement in contrast to joint depression fractures. This may result in tension of soft tissue in the posterior part of the heel. Tension-induced ischemia can result in skin necrosis. The objectives of this study were to investigate whether patients with tongue-type calcaneal fractures exert a higher risk of complications, especially of the posterior soft tissues, than joint depression type fractures. Also, late interventions (e.g., antibiotics, debridements, and amputations) and the effect of timing of surgery on the complication rate was assessed. In this international retrospective cohort study, data of adult patients with a DIACF in the period January 1, 2005-December 31, 2015 were extracted from patients' medical files. Descriptive, univariate, and multivariable analyses were performed in SPSS. A total of 560 patients with 632 DIACF were included (295 tongue-type and 337 non-tongue-type fractures). At hospital presentation, 20.3% of the patients with a tongue-type fracture had compromised posterior soft tissue versus 12.8% with non-tongue-type fractures (p = 0.032). However, corrected for potential confounders the risk was no longer statistically significant (OR 1.497; 95% CI 0.831-2.696). Patients with a TT-DIACF had a 1.2-3.4-fold higher rate of any local wound complication (deep infections, and full thickness lesions, p |
| Databáze: | OpenAIRE |
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