Excessive soft tissue swelling will delay surgery for a proportion of patients admitted with ankle fractures. Surgical and anesthetic teams may waste time assessing patients destined to be cancelled due to swelling. The aim of this investigation was to determine factors associated with cancellation. Case notes of 87 patients (46 male, 41 female), mean age 43 years (range, 13 to 80) who underwent ankle fracture fixation were retrospectively analysed. 31 of 87 ankles (36%) were unsuitable for day after admission surgery due to swelling. Factors investigated included age, gender, mechanism of injury, fracture configuration and necessity for reduction on arrival in the emergency department due to dislocation; each factor was independently analysed for significance using Fisher's exact test.Introduction
Methods
Periprosthetic fracture fixation can be a difficult and complex procedure. The incidence of such fractures is increasing relative to the high prevalence of elderly patients with joint arthroplasty and osteoporosis. Locking plates were introduced for the management of complex periarticular fractures in osteoporotic bone, but there is little information on the use of these plates for the management of periprosthetic fractures. The purpose of this study was to review the early experience with these plates in managing complex Vancouver B1 and C periprosthetic fractures at our academic centre to determine the effectiveness in achieving union, and to identify any potential complications associated with their use. We evaluated the results of Vancouver B1 and type C periprosthetic fractures treated with Synthes LCP. The mean age of the patients at the time of surgery was 76 years. 5 patients were men and 10 were women. There were 8 Vancouver B1 and 7 Vancouver C fractures. 6 fractures had failed previous operative treatment. No patient was lost to follow-up. We assessed time to union, complications, and identified criteria for cortical fixation using these plates.Background
Methods
