Publications by authors named "D H Penning"
Ankle fractures are often accompanied by syndesmotic injuries, contributing to instability and potential long term complications. Syndesmotic injuries are traditionally fixed with either small fragment (3.5-mm diameter) or large fragment (4.
View Article and Find Full Text PDFBackground: It remains unclear whether repairing the deltoid ligament (DL) is beneficial in acute ankle fractures. The aim of this review is to critically review the developments in deltoid ligament repair (DLR) in ankle fractures over the course of 44 years.
Method: An electronic search was conducted on the PubMed and Embase database including comparative studies evaluating the effect of performing DLR in adults suffering from a closed acute ankle fracture with suspected rupture of the DL.
Article Synopsis
- Ankle fracture-dislocations can sometimes require delayed internal fixation, and a study aimed to compare immediate surgical intervention (ORIF) with delayed methods using external fixation or cast splints.
- The study included 447 patients from various hospitals in the Netherlands and found that surgery within 48 hours did not significantly affect unscheduled re-operation rates or surgical site infection (SSI) when compared to delayed options.
- Factors like higher body mass index (BMI) and open fractures increased the likelihood of re-operation, while diabetes and open fractures were linked to higher SSI rates, suggesting that prompt surgery is safe when soft tissue conditions permit it.
Article Synopsis
- The study aimed to assess changes in the management of acute distal tibiofibular syndesmotic injuries among Dutch trauma and orthopedic surgeons through a digital survey.
- Results showed a strong preference for using a single syndesmotic screw (SS) for certain fractures and two screws for Maisonneuve fractures, with a preferred size of 3.5 mm engaging three cortices.
- A significant decline in the routine removal of SSs was noted (23.2% vs. 87.0% in 2012), while the use of suture buttons was less common, indicating a shift in surgical practices over time.
Surgical site infections (SSIs) are among the most clinically relevant complications and the use of prophylactic cefazolin is common practice. However, the knowledge about the pharmacological aspects of prophylactic cefazolin in the lower extremities remains limited. In this prospective cohort, a sub-study of the WIFI-2 randomized controlled trial, adults between 18 and 75 years of age who were scheduled for implant removal below the level of the knee and randomized for cefazolin, was included.
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