The purpose of this study is to determine the financial practicality for the use of nasal povidone-iodine (NP-I) in the preoperative holding area in attempt to decrease the rate of infection that is associated with operative fixation of closed pilon fractures. Institutional costs for treating postoperative infection following a closed pilon fracture, along with costs associated with preoperative NP-I use, were obtained. A break-even equation was used to analyze these costs to determine if the use of NP-I would decrease the current infection rate (17%) enough to be financially beneficial for routine use preoperatively. The total cost of treating a postoperative infection was found to be $18,912, with the cost of NP-I being $30 per patient dose. Considering a 17% infection rate and utilizing the break-even equation, NP-I was found to be economically viable if it decreased the current infection rate by 0.0016% (Number Needed to Treat = 63,051.7). This break-even model suggests that the use of NP-I in the preoperative holding area is financially beneficial for decreasing the rate of infection associated with the treatment of closed pilon fractures.
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http://dx.doi.org/10.1053/j.jfas.2023.09.009 | DOI Listing |
J Orthop Trauma
January 2025
Department of Orthopaedic Surgery, University of California, San Francisco, San Francisco, CA.
Objectives: To describe and enumerate surgeries for patients who underwent reconstruction or amputation after severe distal tibia, ankle, and mid to hindfoot injuries.
Methods: Design: Secondary analysis of a multicenter prospective observational study.
Setting: 31 U.
Int Orthop
January 2025
Department of Orthopaedic Surgery, The Third Hospital of Hebei Medical University, Shijiazhuang, Hebei, People's Republic of China.
Purpose: High Fascial Compartment Pressure (HCP) is one of the most common complications in ankle fractures. This study aimed to investigate the incidence of HCP in pilon fracture and analyze the risk factors of HCP in order to closely monitor its further development into Acute Compartment Syndrome. A nomogram is constructed and validated to predict HCP in patients with pilon fracture.
View Article and Find Full Text PDFJ Orthop Surg Res
November 2024
Department of Rehabilitation Medicine, The Affiliated Hospital of Youjiang Medical University for Nationalities, No.18, Zhongshan 2nd Road, Youjiang District, Baise, 533000, Guangxi, China.
Pak J Med Sci
November 2024
Dr. Nadeem Ahmed, FCPS, Department of Orthopaedics, Surgical Building, Jinnah Postgraduate Medical Centre, Rafiqui Shaheed Road, Karachi, Pakistan.
Objective: This study aimed to evaluate the clinical effectiveness of ORIF versus Ilizarov for the management of Type C closed pilon fractures of the distal tibia at 12 months follow up.
Methods: This retrospective cross sectional study was conducted at Jinnah Postgraduate Medical Center (JPMC) between 29 May 2015 and 27 November 2019 that included patients 18 years and older diagnosed with open AO type C pilon fractures. The primary outcome was the patient-reported Disability Rating Index (DRI) months.
J Orthop Trauma
November 2024
Department of Orthopaedics, R Adams Cowley Shock Trauma Center, University of Maryland School of Medicine, Baltimore, MD.
Objectives: To determine the association between closed suction drainage and postoperative infection in patients with tibial plateau or pilon fractures. Secondarily, this study assessed if intrawound vancomycin powder modified the association of closed surgical drains with infection.
Methods: Design: Secondary analysis of the Effect of Intrawound Vancomycin Powder in Operatively Treated High-risk Tibia Fractures: A Randomized Clinical Trial (VANCO) trial.
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