FTP1.2 Delay in ankle fracture fixation against BOAST guidelines for ankle fractures

Abstract

Abstract Aim Ankle fractures are common, and the majority are the result of low energy torsional trauma. The aim of treatment is to restore and maintain stability and alignment of the joint, ideally with normal anatomy of the ankle mortise. According to BOAST guidelines for ankle fractures, Early fixation within 24-48 hours is recommended in the majority of patients under 60 years when the ankle mortise is unstable. This study aimed at assessing our practice in managing ankle fractures against BOAST guidelines and infection rate assessment. Methods Data was collected respectively from electronic patient records for three months period and entered excel. First cycle results were presented in a departmental audit meeting and recommendations to improve practice were acted upon. Second cycle data was collected three months later and for three months period. Final re-audited results were presented in a departmental audit meeting. Results First cycle results: only 11% of patients had their ankle fractures fixed within 48 hours and none of them had surgical site infection. 65.2 % of patients had their operations over a week with an Infection rate of 10.6%. Second cycle results: 19% of patients had their ankle fractures fixed within 48 hours and none had surgical site infection. 47.6 % of patients had their operations over a week with an Infection rate of 4.8%. Conclusions Second cycle results showed improvement in operative timing and surgical site infections rate against BOAST guidelines compared to initial first cycle results. Early fixation for ankle fractures is associated with lower infection rates.