Abstract
Background With an incidence of 9/1000 per year, ankle fracture is one of the most common skeletal
injuries. It is currently unclear whether time to surgery affects the complication
rate or the hospital length of stay and whether there are confounders in patient characteristics
or comorbidities.
Material and Methods In a retrospective cohort study (n = 421), the risk of perioperative complications
in patients with a primary operative fracture treatment within 6 hours of trauma was
compared to a secondary surgical treatment. Furthermore, the influence of patient
characteristics and comorbidities was examined in a multivariate regression analysis.
Results In comparison to secondary therapy, there was no benefit of a surgical fracture treatment
within 6 hours after trauma was detected with regard to the perioperative complication
rate or the hospital length of stay. Advanced patient age and severe soft tissue damage
were associated with prolonged hospital length of stay but not with an increased rate
of local perioperative complications.
Conclusion The occurrence of severe local perioperative complications after surgical treatment
of an ankle fracture is not associated with the time to surgery or covariates such
as patient age or comorbidities. Current German guidelines for ankle fractures recommend
surgical treatment within 6 – 8 hours, but these should be re-evaluated in further
prospective randomised studies.
Key words
ankle fracture - time to surgery - complication - length of stay
