Frequently Asked Questions

What's the risk of complications for ankle fractures treated with pins or metal screws? I guess they call that internal fixation in medical lingo. My wife is headed into surgery for a calcaneal fracture. She seems prone to any and all problems that can develop. I hate to borrow trouble, but i'd like to be prepared.

Any surgical procedure comes with some risks. There can be problems intra-operatively (during the surgery) or post-operatively (after the operation). There can be technical problems related to the procedure itself or the anesthesia. Afterwards, there is an increased risk of blood clots, infection, and poor wound healing. With bone fractures, failure of the bone to heal (or failure to heal properly) can lead to nonunion or malunion. The surgeon and surgical staff do everything they can to prevent and if not prevent, then minimize problems and complications. Many of the common problems associated with surgery have been reduced and even eliminated with improved surgical techniques and tools. The use of real-time X-ray called fluoroscopy has really boosted results as the surgeon can see what he or she is doing as they are performing the procedure. This has cut down on the number of blood vessels and nerves cut by mistake during the procedure. Having said all that, studies have reported complication rates with internal fixation (use of hardware to fix a bone fracture) as high as 54 per cent for the type of injury your wife has experienced. According to a recent study on this topic, the complication rate does not seem to be linked with age. (There's some thought that older patients are at greater risk for problems than younger patients). Anyone with a poor health history or presence of serious conditions or illnesses such as diabetes or high blood pressure may be at increased risk of complications. Hopefully your wife doesn't fall into any of these categories and will come through this operation in good shape.

Trevor Gaskill, MD, et al. Comparison of Surgical Outcomes of Intra-Articular Calcaneal Fractures by Age. In The Journal of Bone and Joint Surgery. December 15, 2010. Vol. 92-A. No.18. Pp. 2884-2889.

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