A Comparative Analysis of the Most Common Complications for Patients Undergoing Traumatic Foot and Ankle Surgery

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Patient safety is protection from adverse outcome through reduction of complications. The purpose of this study is to accurately identify the most common complications after foot and ankle (FA) and traumatic FA surgery and characterize their incidence compared with all other orthopedic procedures. The American Board of Orthopaedic Surgeons (ABOS) database was searched from 2006 to 2010 for all reported orthopedic and FA procedures. The incidence of complications was identified for the following groups: the 10 most common trauma FA procedures, and all FA procedures cumulatively. The incidence of complications for each group were then compared with all other orthopedic procedures reported during that same period. Statistical analysis was performed using a 2-tailed Student t test and χ2 with Yates. A total of 56,786 FA codes and their associated complication(s) were compared with 429,358 orthopedic codes and their complication(s). The 10 most commonly reported trauma FA procedures accounted for 51% of all FA CPT codes and 46.3% of FA complications. Procedures reporting at least 1 complication were significantly higher for all FA codes when compared with all orthopedic procedures, 13.7% versus 9.2% (P=0.001). The most commonly performed trauma FA procedures had a higher complication rate of 13.5% versus 9.2% (P=0.001). Overall, soft tissue complications (infection, wound dehiscence, and skin ulcer/blister) were each reported significantly more in all FA and trauma FA when compared with other orthopedic procedures (P<0.001). Comprehensive databases, such as the ABOS oral examination case list, can be a valuable tool to direct current practice improvement initiatives and improving patient care. All FA and trauma FA procedures are associated with a higher incidence of complications when compared with all orthopedic surgeries, particularly infection, wound dehiscence, and blistering.

Levels of Evidence: Diagnostic Level III. See Instructions for Authors for a complete description of levels of evidence.

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