{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T23:50:52Z","timestamp":1789170652942,"version":"build-2803163510"},"reference-count":22,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"12","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2021,12]]},"abstract":"<jats:sec>\n            <jats:title>Objectives:<\/jats:title>\n            <jats:p>To examine the incidence of surgical site complications associated with pronation-abduction ankle fracture\u2013dislocations with an open medial tension wound.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Design:<\/jats:title>\n            <jats:p>Retrospective case series.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Setting:<\/jats:title>\n            <jats:p>Accredited Level-1 trauma center.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Patients\/Participants:<\/jats:title>\n            <jats:p>Forty-eight open pronation-abduction ankle fracture\u2013dislocations with medial tension failure wounds treated at our institution from 2014 to 2016.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Intervention:<\/jats:title>\n            <jats:p>Immediate irrigation and debridement along with surgical stabilization of open ankle fracture\u2013dislocation.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Main Outcome Measures:<\/jats:title>\n            <jats:p>The primary outcome measure was deep surgical site infection. Secondary outcome measures included other surgical site complications and adverse radiographic events.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results:<\/jats:title>\n            <jats:p>A total of 5 patients (10.4%) developed a deep surgical site infection requiring additional surgical debridement. One of the patients with a deep surgical site infection required a below-knee amputation as a result of sepsis. Adverse radiographic outcomes included 3 fibular nonunions (6.3%), 3 implant failures related to syndesmotic fixations (6.3%), one periimplant fracture (2.1%), and postoperative collapse of the tibial plafond in 3 patients (6.3%).<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions:<\/jats:title>\n            <jats:p>Open pronation-abduction ankle fracture\u2013dislocations with medial tension failure wounds remain a challenging and potentially devastating injury. Our study suggests that with appropriate surgical debridement, early stabilization, and primary wound closure, acceptable outcomes with a relatively low risk of surgical site complications can be achieved.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Level of Evidence:<\/jats:title>\n            <jats:p>Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1097\/bot.0000000000002128","type":"journal-article","created":{"date-parts":[[2021,3,27]],"date-time":"2021-03-27T05:08:30Z","timestamp":1616821710000},"page":"e481-e485","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":7,"title":["Surgical Site Complications in Open Pronation-Abduction Ankle Fracture\u2013Dislocations With Medial Tension Failure Wounds"],"prefix":"10.1097","volume":"35","author":[{"given":"Case W.","family":"Martin","sequence":"first","affiliation":[{"name":"Department of Orthopaedics, University of Texas Health San Antonio, San Antonio, TX;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James C.","family":"Ryan","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, University of Texas Health San Antonio, San Antonio, TX;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Travis S.","family":"Bullock","sequence":"additional","affiliation":[{"name":"University of Texas Health San Antonio, Long School of Medicine, San Antonio, TX; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John H.","family":"Cabot","sequence":"additional","affiliation":[{"name":"University of Texas Health San Antonio, Long School of Medicine, San Antonio, TX; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahmed A.","family":"Makhani","sequence":"additional","affiliation":[{"name":"University of Texas Health San Antonio, Long School of Medicine, San Antonio, TX; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leah P.","family":"Griffin","sequence":"additional","affiliation":[{"name":"Medical Solutions Division, 3M Health Care, San Antonio, TX."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Boris A.","family":"Zelle","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, University of Texas Health San Antonio, San Antonio, TX;"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"R1-20250614","doi-asserted-by":"crossref","first-page":"891","DOI":"10.1016\/j.injury.2011.12.007","article-title":"The epidemiology of open fractures in adults. 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