Review Question - QID 6752

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Calcaneus Fractures Epidemiology Anatomic location QID: 6752 (SAE09FA.64)

QID 6752 (Type "6752" in App Search)

Figures 29a and 29b show a clinical photograph and radiographs of a patient who sustained an open calcaneus fracture in a motor vehicle accident. The patient received immediate IV antibiotics and an emergent irrigation and debridement. The swelling has subsided by 3 weeks and the medial wound is clean. What do you tell the patient about the likelihood of infection if a formal open reduction and internal fixation via a lateral approach is performed?

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There is no significant difference between the infection rate for this fracture and a similar closed fracture.

46%

248/540

Due to the risk of infection, open reduction and internal fixation is not recommended for this fracture.

9/540

The infection rate is three to five times more likely with this fracture.

45%

245/540

Due to the risk of infection from a lateral approach, treatment is confined to limited internal fixation or an external fixator.

20/540

The patient will need to undergo 3 weeks of IV antibiotics at home.

4/540

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Multiple authors have shown similar infection rates for grade 1 and 2 open medial fractures and closed fractures that have been treated with an extensile lateral approach and open reduction and internal fixation. Patients only need IV antibiotics for 2 to 3 days after surgery. Formal open reduction and internal fixation is not recommended for grade 3 medial wounds and most lateral wounds.