Risk Factors for Aseptic Revision of Surgically-Treated Ankle Fractures

Abstract

Category: Trauma; Ankle Introduction/Purpose: Early revision rates within 12 months after ankle fracture open reduction internal fixation (ORIF) are fairly low, however remain relevant given the sheer volume of ankle fractures which occur each year. Understanding these rates is complex because reoperation due to technical or mechanical complications - such as malunion, inadequate reduction or fixation failure - are typically reported alongside returns to the operating room for soft-tissue related problems like wound dehiscence or infection. There is limited data identifying risk factors specifically for revision of ankle fracture fixation in the absence of soft-tissue complications. Understanding variables which predispose to aseptic technical and mechanical failure without this confounder may provide insight and improve patient care. Methods: The purpose was to identify risk factors for aseptic revision of ankle fracture within ORIF 1 year of primary operation. A retrospective cohort study was performed at two large academic medical centers. Research Patient Data Registry (RPDR) data available from 2002-2019 was used to identify patients who underwent aseptic revision of ankle fracture ORIF within 12mo of their primary ORIF. Patients were excluded if SCS) on immediate post- operative imaging (aOR=28.4; 95% CI: 5.53, 267; P SCS) on immediate post- operative imaging (aOR=28.4), more severe initial fracture displacement (ARCS Type C) (aOR=25.8), substance abuse (aOR=15.7) and polytrauma (aOR=12.3). Identifying these factors may allow surgeons to better counsel their patients and discuss risk during the informed consent process. These may also serve as future targets for intervention aimed at improving patient safety and outcomes follow ankle fracture ORIF.