Andersen Mette Renate, Frihagen Frede, Madsen Jan Erik, Figved Wender
Department of Orthopaedic Surgery, Baerum Hospital, Drammen, Norway.
Department of Orthopaedic Surgery, Division of Surgery and Clinical Neuroscience, Oslo University Hospital, Oslo, Norway.
Injury. 2015 Nov;46(11):2283-7. doi: 10.1016/j.injury.2015.08.021. Epub 2015 Aug 21.
The aim of this study was to determine the rate of complications after routine syndesmotic screw removal.
All patients who underwent syndesmotic screw removal at our hospital between 2007 and 2012 were included in the study. Patient demographics, surgical characteristics, radiographic evaluation and complications were recorded from the patients' charts. Questionnaires were sent by postal mail to all patients, to measure patient satisfaction and pain (VAS scales).
161 patients were included in the trial. A wound infection was found in 8 (5%) patients. 3 were regarded as serious infections requiring hospitalisation and intravenous antibiotics, 2 of those required surgical revisions. 5 patients were treated by oral antibiotics. Staphylococcus aureus was identified as the causing organism in all (6/8) cases with a positive culture. The patients with postoperative infection reported more pain (5.3 vs. 2.3; p=0.02) and were less satisfied (4.7 vs. 7.6; p=0.014) with their ankle compared to those without infection (T-test for independent samples).
There were 5% wound infections after routine syndesmotic screw removal. Routine antibiotic prophylaxis effective against S. aureus should be administered when removing syndesmotic screws. In our institution we now use one single dose Cefalotin of 2g intravenously 30-60min before screw removal.
本研究的目的是确定常规下胫腓联合螺钉取出术后的并发症发生率。
纳入2007年至2012年间在我院接受下胫腓联合螺钉取出术的所有患者。从患者病历中记录患者人口统计学资料、手术特征、影像学评估及并发症情况。通过邮政邮件向所有患者发送问卷，以评估患者满意度和疼痛程度（视觉模拟评分量表）。
161例患者纳入试验。8例（5%）患者发生伤口感染。3例被视为严重感染，需要住院并静脉使用抗生素，其中2例需要手术翻修。5例患者接受口服抗生素治疗。所有培养结果阳性的病例（6/8）中均鉴定出金黄色葡萄球菌为致病微生物。与未感染患者相比，术后感染患者报告的疼痛更严重（5.3对2.3；p=0.02），对踝关节的满意度更低（4.7对7.6；p=0.014）（独立样本t检验）。
常规下胫腓联合螺钉取出术后伤口感染率为5%。取出下胫腓联合螺钉时应给予对金黄色葡萄球菌有效的常规抗生素预防。在我们机构，现在在取出螺钉前30 - 60分钟静脉注射单剂量2g头孢噻吩。
