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. 2021 Sep;45(9):2395-2400.
doi: 10.1007/s00264-020-04768-7. Epub 2020 Aug 8.

Outpatient surgery in patients with ankle fractures minimises hospital admissions and utilisation of healthcare resources

Travis S Bullock  1 , Jose M Gutierrez-Naranjo  2 , Robert G DelBello  1 , Ravi A Karia  2 , Boris A Zelle  3
Affiliations

Outpatient surgery in patients with ankle fractures minimises hospital admissions and utilisation of healthcare resources

Travis S Bullock et al. Int Orthop. 2021 Sep.

Abstract

Purpose: The recent outbreak of the novel coronavirus (SARS-CoV-2) has emphasised the need to minimise hospital admissions and utilisation of healthcare resources. The purpose of this study was to examine the outcomes of an outpatient surgery protocol for acute closed ankle fractures.

Methods: In this retrospective study, 262 patients underwent outpatient surgery for their closed ankle fractures at our level-1 trauma centre. A total of 196 patients met our inclusion criteria and were ultimately included in the final analysis. Our primary outcomes' measures included post-operative admission to the emergency department within 30 days after surgery and unplanned hospital readmission within 30 days after surgery. Our secondary outcome measure included the incidence of surgical site infection (SSI) within 12 weeks after surgery.

Results: Thirty-two patients (16.3%) had an unplanned emergency department visit within 30 days of fracture fixation and two patients (1.0%) required hospital readmission within 30 days of their surgery. Sixteen patients (8.2%) developed SSI, which included 11 (5.6%) superficial and five (2.6%) deep infections.

Conclusion: Strategic outpatient management of acute closed ankle fractures is associated with acceptable rates of unplanned emergency department visits, hospital readmissions, and SSIs. In the context of the recent SARS-CoV-2 outbreak, outpatient management of these injuries may aide in the mitigation of nosocomial infections and the preservation of finite healthcare resources.

Keywords: Ankle fracture; COVID-19; Open reduction and internal fixation; Outpatient; SARS-CoV-2.

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