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Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
Published in: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine 1/2015

Open Access 01-12-2015 | Original research

Risk factors for wound complications of closed calcaneal fractures after surgery: a systematic review and meta-analysis

Authors: Wei Zhang, Erman Chen, Deting Xue, Houfa Yin, Zhijun Pan

Published in: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine | Issue 1/2015

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Abstract

Background

To better clinical outcomes, open reduction and internal fixations (ORIFs) have been commonly performed in the case of closed displaced intra-articular calcaneal fractures (CDICFs). Nonetheless, postoperative wound complications remain a significant problem. Therefore, the aim of our study is to summarise relevant evidence investigating the risk factors for postoperative wound complications of CDICFs following ORIFs.

Methods

A meta-analysis was conducted on relevant clinical studies to identify the risk factors for wound complications of CDICFs after ORIFs. Electronic databases were searched for all relevant studies up to October 2014. The Newcastle-Ottawa scale was used to evaluate the methodological quality, and study-specific odds ratios (ORs) were pooled using the fixed-effects model or random-effects model. Sensitivity analysis and meta-regression analysis was performed to evaluate the heterogeneity.

Results

Ten observational studies involving 1559 patients with 1651 fractures were included in this meta-analysis. The results showed that diabetes (OR, 9.76; p < 0.01), no drainage (OR, 5.86; p < 0.01), fracture severity (OR, 3.31; p < 0.01) and bone graft (OR, 1.74; p < 0.01) were the risk factors for wound complications of CDICFs after ORIFs. A trend of more wound complications in patients with a history of smoking was detected. However, female patients, ORIFs performed within 14 days of injury, smoking, hypertension and drinking did not significantly increase the risk of wound complications (p > 0.05).

Conclusions

Based on available relevant evidence, bone graft, diabetes, no drainage and fracture severity were all associated with an increased risk of wound complications after ORIF for CDICFs.
Appendix
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Metadata
Title
Risk factors for wound complications of closed calcaneal fractures after surgery: a systematic review and meta-analysis
Authors
Wei Zhang
Erman Chen
Deting Xue
Houfa Yin
Zhijun Pan
Publication date
01-12-2015
Publisher
BioMed Central
DOI
https://doi.org/10.1186/s13049-015-0092-4

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