Risk Factors for Short-Term Complication After Open Reduction and Internal Fixation of Ankle Fractures: Analysis of a Large Insurance Claims Database

Daniel C. Jupiter, En Shuo Hsu, George Tye Liu, John G. Reilly, Naohiro Shibuya

Research output: Contribution to journalArticle

Abstract

Although fractures of the ankle are common injuries treated by surgical podiatrists and orthopaedic surgeons specializing in foot and ankle surgery, postoperative complications can occur, often imposing an economic burden on the patient. As health care in the United States moves toward value-based care, cost reduction has primarily focused on reducing complications and unplanned episodes of care. We used a large modern database of insurance claims to examine patterns of complications after open reduction internal fixation of ankle fractures, identifying diabetes mellitus and history of myocardial infarction as risk factors for postoperative infection within 30 days of surgery. Lateral malleolar repair was less likely to lead to infection, or need for repeated surgery, than was medial malleolar fracture repair. Diabetes mellitus, neuropathy, and chronic obstructive pulmonary disease were associated with development of postoperative cellulitis. Patients with a history of cerebrovascular accident were more likely to return to the emergency department or to have a pulmonary embolism. Male sex, presence of lupus, and increased age were associated with repeat surgery.

Original languageEnglish (US)
Pages (from-to)239-245
Number of pages7
JournalJournal of Foot and Ankle Surgery
Volume59
Issue number2
DOIs
StatePublished - Mar 1 2020

Keywords

  • 2
  • ankle fracture
  • complications
  • deep venous thrombosis
  • infection
  • pulmonary embolism
  • trauma

ASJC Scopus subject areas

  • Surgery
  • Orthopedics and Sports Medicine

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