Briggs Praise Kess, Shetty Sowkoor Jeevith, Faraj Adnan Abdulmajeed
Specialty Registrar, Trauma and Orthopaedics, Scarborough General Hospital, Scarborough, YO12 6QL, United Kingdom.
Core Trainee, Trauma and Orthopaedics, Scarborough General Hospital, Scarborough, YO12 6QL, United Kingdom.
J Clin Orthop Trauma. 2025 Mar 4;64:102955. doi: 10.1016/j.jcot.2025.102955. eCollection 2025 May.
The management of ankle fracture blisters is contentious. This study aims to evaluate the management of ankle fracture blisters among orthopedic surgeons in Yorkshire and establish a consensus.
A questionnaire was distributed among Orthopaedic Surgeons in Yorkshire, United Kingdom, to gain insight into their management of ankle fracture blisters. Responses were processed in Excel spreadsheet, chi-squared analysis was done, comparing the responses of foot and ankle surgeons with other orthopaedic surgeons.
There were 69 respondents (58 % of whom were consultants, 7 % associate specialists and 35 % registrars) out of 125 surgeons invited to participate (55.2 % response rate). 17 were foot and ankle surgeons. For most respondents, the type of blister (haemorrhagic or serosanguinous) does not affect decision around timing of surgery. 76 % say that blister location affects the placement of skin incision. 19 % would make their skin incisions irrespective of blister location and 5 % had variable responses to this. 43 surgeons would defer the surgical fixation of the fracture if the blister were at the incision site, while 22 (32 %) would defer surgery if blister is extensive, but not as incision site. If surgery is deferred because of the blister, 52 % will wait till skin creases return while others would wait a variable period. While waiting, 67 % would immobilize with a plaster cast if appropriate, 56 % would use an external fixator. 65 % think that blisters increase the risk of infection, however, 97 % will not prescribe any systemic antibiotics for ankle fracture blisters. The most preferred dressing for blisters is Inadine and Mepitel.
Majority of Orthopaedic Surgeons in Yorkshire consider ankle fracture blisters to be significant in determining the management of patients with ankle fractures; however significantly more foot and ankle surgeons opine that blisters should not cause delay in definitive fixation of ankle fractures.
踝关节骨折水疱的处理存在争议。本研究旨在评估约克郡骨科医生对踝关节骨折水疱的处理情况并达成共识。
向英国约克郡的骨科医生发放问卷，以深入了解他们对踝关节骨折水疱的处理方式。问卷回复在Excel电子表格中进行处理，采用卡方分析，比较足踝外科医生与其他骨科医生的回复。
在受邀参与的125名外科医生中，有69名回复（回复率为55.2%），其中58%为顾问医生，7%为副专科医生，35%为住院医生。17名是足踝外科医生。对于大多数受访者来说，水疱类型（出血性或浆液性）不影响手术时机的决策。76%的人表示水疱位置会影响皮肤切口的位置。19%的人无论水疱位置如何都会进行皮肤切口，5%的人对此有不同的回复。如果水疱位于切口部位，43名外科医生会推迟骨折的手术固定，而如果水疱广泛但不在切口部位，22名（32%）外科医生会推迟手术。如果因水疱而推迟手术，52%的人会等到皮肤褶皱恢复，其他人会等待不同的时间。在等待期间，67%的人会在适当的时候用石膏固定，56%的人会使用外固定器。65%的人认为水疱会增加感染风险，然而，97%的人不会为踝关节骨折水疱开任何全身性抗生素。水疱最常用的敷料是碘伏纱布和美皮贴。
约克郡的大多数骨科医生认为踝关节骨折水疱对踝关节骨折患者的处理有重要影响；然而，明显更多的足踝外科医生认为水疱不应导致踝关节骨折确定性固定的延迟。
