Abstracts Posters SICOT-SOF meeting Gothenburg 2010 _2_

Poster
Topic: Trauma - Ankle / Foot
Abstract number: 25592
TREATMENT OPTIONS IN OPEN TRAUMA OF THE ANKLE JOINT
Olivera LUPESCU, Mihail NAGEA, Cristina PATRU, Bogdan Paul DUICA, Doriana
LUPESCU
University Of Medicine and Pharmacy, Emergency Hospital, Bucharest, Bucharest
(ROMANIA)
Therapeutic rules are relatively clear in closed trauma of the ankle, while skin injury
makes sometimes difficult the choice between different techniques, concerning the
incision and the type of bone stabilization, definitely influenced by the time from
trauma and by the injury of the skin. The authors analize 20 patients with open ankle
trauma, operated between 01.01.2005-01.01.2008, age 24-52 yrs. The injuries were
both bony and capsular-ligamentous in 13 cases, while 3 patients had open
dislocations without fractures. Following Gustillo-Andersen classification, the injuries
were type I-2 cases (12.5%), type II-6 cases (37.5%), type III-8 cases (50%).
Different therapeutical problems were raised for each type of open injury requiring
different surgical techniques, follow-up was performed until 24 months. Postoperative
outcome was evaluated from the point of view of: functional recovery,
social and professional re-integration, the incidence of the complications. The
circumstances influencing post-operative outcome were: the time between trauma
and surgery, the type of the skin and soft tissue injuries. Septic complications
appeared in 12.5% cases (2 patients) with Staphylococcus aureus, without the need
of implant removal. Because one of the 3 cases with type III C injury arrived at our
hospital 36 hrs after trauma with irreversible ischemia, amputation was indicated. The
treatment of open trauma of the ankle is difficult since the cutaneous injury narrows
the therapeutical options and post-operative complications are more frequent. The
key of success in these cases is represented by early surgery adapted to the soft
tissue injury.
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