The Influence of Timing of Surgery on Postoperative Length of Hospital Stay in Closed Ankle Fractures.

Background Ankle fractures are prevalent lower limb injuries that often necessitate surgical intervention to restore joint stability and functionality. Delays in surgical management can extend hospital stays and elevate the risk of complications. This study aims to evaluate the effect of surgical timing on the postoperative length of hospital stay in patients with closed ankle fractures managed through open reduction and internal fixation (ORIF). Objective The objective of this study was to determine whether early surgical intervention (within eight hours of injury) reduces the mean postoperative length of hospital stay compared to delayed surgery (after eight hours) in patients with closed ankle fractures undergoing open reduction and internal fixation (ORIF). Methods A retrospective cohort study was conducted over six months, from February 26, 2021, to August 26, 2021, involving 80 patients with closed ankle fractures treated at the Orthopaedic Surgery Department of Benazir Bhutto Hospital, Rawalpindi. Patients were categorized into two cohorts based on the time elapsed between injury and surgical intervention: early surgery (≤8 hours, n=43) and late surgery (>8 hours, n=37). The primary outcome measured was the length of hospital stay following ORIF. Data were analyzed using the Statistical Package for the Social Sciences (SPSS) version 23 (IBM Corp., Armonk, NY. US). Independent sample t-tests, chi-square tests, and analysis of variance (ANOVA) were employed to assess differences between cohorts, with a p-value of less than 0.05 considered statistically significant. Results The mean age of the patients was 43.90 ± 14.64 years, comprising 58 (72.5%) males and 22 (27.5%) females. The overall mean length of hospital stay was 2.67 ± 0.87 days. Patients who underwent late surgery had a significantly longer hospital stay (mean 3.04 ± 0.80 days, n=37) compared to those treated early (mean 2.36 ± 0.82 days, n=43), with a p-value of <0.001. The stratified analysis revealed similar trends across various subgroups, including age and gender. Conclusion This retrospective cohort study concludes that delayed surgical management of closed ankle fractures is associated with a longer hospital stay compared to early intervention. These findings advocate for prompt surgical treatment to enhance patient outcomes by reducing postoperative hospitalization durations.