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Introduction: Studies have suggested a strong association between depression and poor outcomes following various orthopaedic surgeries. However, depression's impact on complications following open reduction/internal fixation (ORIF) of trimalleolar fractures has not been elucidated. Therefore, this study aimed to determine whether depression is associated with higher rates of readmissions and medical complications following ORIF of trimalleolar fractures.
Methods: A database query from January, 2020, through March, 2021, identifying adults who underwent trimalleolar ORIF generated 50 154 patients. Those with depression were matched 1:1 to controls without depression by age, sex, chronic obstructive pulmonary disease, anxiety, and other prominent comorbidities. Primary endpoints compared 90-day all-cause readmissions and medical complications. Odds ratios (ORs) of the effect of depression on readmissions and medical complications were calculated.
Results: Patients with depression who underwent ORIF of trimalleolar fractures had significantly higher odds of being readmitted within 90 days of the initial procedure (OR: 1.37; P < .0001). Ninety-day odds of developing medical complications were significantly higher (OR: 4.61; P < .0001) in patients with depression compared with patients within the control group.
Conclusion: Patients with depression undergoing trimalleolar ORIF face an increased risk of readmission and multiple postoperative complications. Orthopaedic surgeons should factor depression into their preoperative evaluation, given the already high burden of complications following ORIF of trimalleolar fractures.
Level Of Evidence: Level III: Retrospective cohort study.
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http://dx.doi.org/10.1177/19386400241267019 | DOI Listing |
J Am Acad Orthop Surg
August 2025
From the Department of Medical Education, Texas A&M College of Medicine, Dallas, TX (Sontam, Toussaint, Hlavinka, Chavda, and Mbilinyi), and the Department of Orthopedic Surgery, Baylor University Medical Center, Dallas, TX (Zide).
Background: Smoking is a well-established risk factor for postoperative complications following open reduction and internal fixation (ORIF) for rotational ankle fractures. However, the effect of non-tobacco nicotine (NTN) use on these outcomes remains unclear, despite the increasing use of products such as vapes. This retrospective cohort study investigates whether perioperative NTN use is associated with increased postoperative complications following ankle ORIF compared with a nicotine-independent (NI) control group.
View Article and Find Full Text PDFJ Foot Ankle Surg
August 2025
Luminis Health, Department of Orthopedics, Annapolis, MD, USA. Electronic address:
Background: Traditionally, open reduction and internal fixation (ORIF) for Weber B fibular fractures involves placement of a lag screw across the fracture plane along with plate fixation.
Purpose: To compare outcomes of Weber B fractures treated with plate-only (PO) vs. plate and lag screw (PLS) fixation.
Medicina (Kaunas)
August 2025
Department of General Surgery and Medical Surgical Specialties, Section of Orthopaedics and Traumatology, Policlinico Rodolico-San Marco, University of Catania, 95123 Catania, Italy.
: Ankle fractures represent one of the most common injuries to the lower limb, particularly impacting women and the elderly. The coronavirus disease 2019 (COVID-19) pandemic greatly disrupted both the incidence of these fractures and their treatment patterns globally. This retrospective epidemiological study analyzed 1010 cases of ankle fractures treated at the Orthopedics Department of Policlinico University Hospital in Catania from 2018 to 2023.
View Article and Find Full Text PDFClin Case Rep
August 2025
Division of Pain Medicine, Department of Anesthesiology and Perioperative Medicine, David Geffen School of Medicine University of California, Los Angeles Los Angeles California USA.
Individualized opioid-free perioperative management, combining dual continuous peripheral nerve catheters targeting the popliteal sciatic and adductor canal nerves, non-opioid pharmacologic agents, and adjunctive neuromodulation, offers robust multimodal analgesia. This approach supports both ORIF and hardware removal in complex trimalleolar fractures while preserving function, reducing opioid-related risks, and promoting faster recovery.
View Article and Find Full Text PDFFoot (Edinb)
March 2025
The Rotherham NHS Foundation Trust, Rotherham, UK.
Background: Ankle fractures comprise 10 % of fractures seen in ED. Despite this, debate remains regarding the optimal timing of surgery and weight bearing post-operatively. There is no clear consensus whether delaying ankle ORIF leads to better outcomes.
View Article and Find Full Text PDF