Long School of Medicine, UT Health San Antonio, San Antonio, TX, 78229-3900, USA.
Department of Orthopaedics, UT Health San Antonio, Floyd Curl Dr, MC 7774, San Antonio, TX, 78229-3900, USA.
Int Orthop. 2021 Sep;45(9):2395-2400. doi: 10.1007/s00264-020-04768-7. Epub 2020 Aug 8.
The recent outbreak of the novel coronavirus (SARS-CoV-2) has emphasised the need to minimise hospital admissions and utilisation of healthcare resources. The purpose of this study was to examine the outcomes of an outpatient surgery protocol for acute closed ankle fractures.
In this retrospective study, 262 patients underwent outpatient surgery for their closed ankle fractures at our level-1 trauma centre. A total of 196 patients met our inclusion criteria and were ultimately included in the final analysis. Our primary outcomes' measures included post-operative admission to the emergency department within 30 days after surgery and unplanned hospital readmission within 30 days after surgery. Our secondary outcome measure included the incidence of surgical site infection (SSI) within 12 weeks after surgery.
Thirty-two patients (16.3%) had an unplanned emergency department visit within 30 days of fracture fixation and two patients (1.0%) required hospital readmission within 30 days of their surgery. Sixteen patients (8.2%) developed SSI, which included 11 (5.6%) superficial and five (2.6%) deep infections.
Strategic outpatient management of acute closed ankle fractures is associated with acceptable rates of unplanned emergency department visits, hospital readmissions, and SSIs. In the context of the recent SARS-CoV-2 outbreak, outpatient management of these injuries may aide in the mitigation of nosocomial infections and the preservation of finite healthcare resources.
新型冠状病毒(SARS-CoV-2)的爆发强调了尽量减少医院收治和使用医疗资源的必要性。本研究旨在探讨急性闭合性踝关节骨折门诊手术方案的结果。
在这项回顾性研究中,我们在一级创伤中心对 262 例闭合性踝关节骨折患者进行了门诊手术。共有 196 名患者符合我们的纳入标准,并最终纳入了最终分析。我们的主要结局测量指标包括术后 30 天内急诊就诊和术后 30 天内计划外再次住院。我们的次要结局测量指标包括术后 12 周内手术部位感染(SSI)的发生率。
32 名患者(16.3%)在骨折固定后 30 天内计划外急诊就诊,2 名患者(1.0%)在手术后 30 天内需要再次住院。16 名患者(8.2%)发生 SSI,其中 11 名(5.6%)为浅表感染,5 名(2.6%)为深部感染。
对急性闭合性踝关节骨折进行策略性门诊管理与可接受的计划外急诊就诊、再次住院和 SSI 发生率相关。在最近的 SARS-CoV-2 爆发背景下,对这些损伤进行门诊管理可能有助于减少医院感染和保护有限的医疗资源。