Publications

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Journal of general internal medicine

Hearts and Minds: an Exercise in Clinical Reasoning.

2021

Authors: Mayfield JJ, McKee KY, Zier LS, Kohlwes RJ

Arthritis care & research

Race, Ethnicity and Disparities in Rheumatology Educational Materials.

2021

Authors: Strait A, Graf J, Margaretten M, Yazdany J, Goglin S

American journal of industrial medicine

Early radiographic pneumoconiosis is associated with impaired exercise gas exchange among coal miners with normal resting spirometry.

2021

Authors: Gandhi SA, Cohen RA, Blanc PD, Go LHT

Contemporary clinical trials

SACRED: Effect of simvastatin on hepatic decompensation and death in subjects with high-risk compensated cirrhosis: Statins and Cirrhosis: Reducing Events of Decompensation.

2021

Authors: Kaplan DE, Mehta R, Garcia-Tsao G, Albrecht J, Aytaman A, Baffy G, Bajaj J, Hernaez R, Hunt K, Ioannou G, Johnson K, Kanwal F, Lee TH, Monto A, Pandya P, Schaubel D, Taddei TH

Journal of orthopaedic trauma

Surgical site complications in open pronation-abduction ankle fracture-dislocations with medial tension failure wounds.

2021

Authors: Martin CW, Ryan JC, Bullock TS, Cabot JH, Makhani AA, Griffin LP, Zelle BA

View Abstract

OBJECTIVES

To examine the incidence of surgical site complications associated with pronation-abduction ankle fracture-dislocations with an open medial tension wound.

DESIGN

Retrospective case series.

SETTING

Accredited level-1 trauma center.Patients/Participants: Forty-eight open pronation-abduction ankle fracture-dislocations with medial tension failure wounds treated at our institution from 2014 to 2016.

INTERVENTION

Immediate irrigation and debridement along with surgical stabilization of open ankle fracture-dislocation.

MAIN OUTCOME MEASUREMENTS

The primary outcome measure was deep surgical site infection. Secondary outcome measures included other surgical site complications and adverse radiographic events.

RESULTS

A total of five patients (10.4%) developed a deep surgical site infection requiring additional surgical debridements. One of the patients with a deep surgical site infection required a below-knee amputation as a result of sepsis. Adverse radiographic outcomes included three fibular nonunions (6.3%), three implant failures related to syndesmotic fixations (6.3%), one peri-implant fracture (2.1%), and postoperative collapse of the tibial plafond in three patients (6.3%).

CONCLUSIONS

Open pronation-abduction ankle fracture-dislocations with medial tension failure wounds remain a challenging and potentially devastating injury. Our study suggests that with appropriate surgical debridement, early stabilization, and primary wound closure, acceptable outcomes with a relatively low risk of surgical site complications can be achieved.