Preoperative CT parameters to predict tibiofibular syndesmosis injury associated with ankle fracture: a propensity score-matched analysis.

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Abstract

[Indexed for MEDLINE] 20. J Foot Ankle Surg. 2023 May-Jun;62(3):455-457. doi: 10.1053/j.jfas.2022.11.005. Epub 2022 Nov 20. Factors Associated With Successful Closed Reduction of Dislocated Ankle Fractures at a US Level-1 Trauma Center. Levi J(1), Heineman K(1), Sansosti LE(2), Meyr AJ(3). Author information: (1)Resident, Temple University Hospital Podiatric Surgical Residency Program, Philadelphia, PA. (2)Clinical Assistant Professor, Department of Podiatric Surgery, Temple University School of Podiatric Medicine, Philadelphia, PA. (3)Clinical Professor, Department of Podiatric Surgery, Temple University School of Podiatric Medicine, Philadelphia, PA. Electronic address: ajmeyr@gmail.com. Dislocated ankle fractures represent a common presenting pathology at US emergency departments, and several different procedural and anesthetic techniques are employed for attempted closed reduction of these injuries. The objective of this investigation was to evaluate the frequency of and factors associated with success in the closed reduction of dislocated ankle fractures. A diagnostic code search produced 1050 ankle fractures presenting to an urban US level-1 emergency department. These medical records were interrogated and first categorized into whether or not a closed reduction was attempted. Those identified closed reduction attempts were further categorized into whether the attempt was successful. A comparative analysis was subsequently performed of variables associated with procedure success. Of the 1050, 97 (9.2%) required closed reduction and of these, 76 (78.4%) were successfully closed reduced on the first attempt. No differences were observed in initial procedure success with respect to subject age (p = .701), subject gender (p = .623), fracture laterality (p = 1.00), open versus closed injuries (p = .282), fracture mechanism (p = 1.00), utilized anesthetic technique (p value range 0.291-0.616), or the specialty performing the reduction (p-value range 0.402-1.00). A descriptive subanalysis was performed on those fractures with an unsuccessful first closed reduction attempt. It is our hope that this investigation adds to the body of knowledge with respect to a commonly performed procedure by foot and ankle surgeons. Copyright © 2022 the American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved. DOI: 10.1053/j.jfas.2022.11.005