Fracture blisters: predictors for time to definitive fixation in pilon fractures

• Published in: European journal of orthopaedic surgery & traumatology 2024-01, Vol.34 (1), p.161-166
• Main Authors: Korrapati, Avinaash, Ta, Canhnghi N., Mitchell, Brendon C., Wall, Pelle V., Gurusamy, Pradyumna, Dwight, Kathryn, Girard, Paul J., Schwartz, Alexandra K., Kent, William T.
• Format: Article
• Language: English
• Subjects: Alcohol; Ankle; Demographics; Diabetes; Hypertension; Injuries; Medicine; Medicine & Public Health; Original; Original Article; Orthopedics; Patients; Surgeons; Surgery; Surgical Orthopedics; Trauma; Traumatic Surgery; Wound healing
• ISSN: 1432-1068; 1633-8065; 1432-1068
• DOI: 10.1007/s00590-023-03623-w

Purpose Fracture blisters, a common soft-tissue complication of pilon fractures, are associated with post-operative wound infections, delays in definitive fixation, and alterations in surgical plan. The purpose of this study was to (1) identify the delay in surgery attributable to the presence fracture blisters and (2) investigate the relationship of fracture blisters to comorbidities and fracture severity. Methods Patients with pilon fractures at an urban level 1 Trauma center from 2010 to 2021 were identified. The presence or absence of fracture blisters was noted, along with location. Demographic information, time from injury to external fixator placement, and time to definitive open reduction internal fixation (ORIF) were collected. Pilon fractures were classified according to AO/OTA guidelines using CT imaging and plain radiographs. Results 314 patients with pilon fractures were available for analysis, eighty (25%) of whom were found to have fracture blisters. Patients with fracture blisters had longer time to surgery compared to those without fracture blisters (14.2 days vs 7.9 days, p