Abstract
Introduction: It is commonly believed that delay in fracture fixation of more than two weeks results in increased Surgical Time (ST), due to scar and callus formation at the fracture site. Reducing ST can lower hospital costs and decrease radiation exposure. Methods and Results: A retrospective chart review was conducted to investigate whether early fracture care (up to 2 days after injury) results in decreased ST and radiation exposure compared to delayed fracture care (> 14 days after injury) for distal radius and bimalleolar ankle fractures. A total of 581 radius and ankle fractures that underwent surgical fixation between 2014 and 2017 were identified from the OR registry. Cases with only a single volar locking plate for the distal radius and constructs consisting of 2 medial malleolar screws, third tubular plate, and up to 1 syndesmotic screw for the ankle were included. The mean ST for distal radius cases done up to 2 days after injury was significantly greater than ST for distal radius cases done > 14 days after injury (125.78±29.75 minutes versus 105.83±24.82 minutes respectively , p=0.06). The mean ST for ankle fracture cases done less than 2 days did not differ from ST for ankle fracture cases done > 14 days after injury (140.86±28.15 minutes versus 173.22±39.98 minutes respectively, p=0.06). Conclusion: There was no significant difference in radiation exposure. Delaying surgery for distal radius and bimalleolar ankle fractures > 14 days after injury does not seem to significantly affect the duration of surgery or radiation exposure.
Highlights
It is commonly believed that delay in fracture fixation of more than two weeks results in increased Surgical Time (ST), due to scar and callus formation at the fracture site
Open Reduction and Internal Fixation (ORIF) of radius and ankle fracture surgeries are some of the most common cases seen by orthopedic surgeons today
The goal of this study is to investigate whether early fracture care (≤ 2 days after injury) results in decreased surgery time and radiation exposure compared to delayed fracture care (> 14 days after injury) for bimalleolar ankle and distal radius fractures
Summary
It is commonly believed that delay in fracture fixation of more than two weeks results in increased Surgical Time (ST), due to scar and callus formation at the fracture site. Open Reduction and Internal Fixation (ORIF) of radius and ankle fracture surgeries are some of the most common cases seen by orthopedic surgeons today. Distal radius fractures make up 20% of all fractures treated in the emergency room and make 8% to 15% of all bone-related injuries in adults [1, 2]. Ankle fractures have an incidence rate of 174 fractures per 100,000 adults every year [3]. The costs of treating these fractures are rising. In 2007, Medicare paid $170 million in distal radius fracture treatment payments, and it is projected that the costs could increase to $240 million if internal fixation continues to be used [4]. The economic burden for foot and ankle surgery was $11 Billion for the Medicare
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