Abstract | BACKGROUND: METHODS: Between October 2000 and November 2006, 501 patients who underwent surgical fixation of an unstable ankle fracture were followed prospectively. Patients receiving spinal anesthesia were compared with a cohort who received general anesthesia. All patients were evaluated at three, six, and twelve months postoperatively with use of standardized, validated general and limb-specific outcome instruments. Standard and multivariable analyses comparing outcomes at these intervals were performed. RESULTS: Four hundred and sixty-six patients (93%) who had been followed for a minimum of one year met the inclusion criteria. Compared with the general anesthesia group, the spinal anesthesia group had a greater mean age (p = 0.005), higher classification on the American Society of Anesthesiologists system (p = 0.03), and a greater number of patients with diabetes (p = 0.02). There was no difference in sex distribution between the groups. At three months, patients who received spinal anesthesia had significantly better pain scores (p = 0.03) and total scores on the American Orthopaedic Foot and Ankle Society outcome instrument (p = 0.02). At six months, patients in the spinal anesthesia group continued to have better pain scores (p = 0.04), but there was no longer a difference in total scores (p = 0.06). At twelve months, no difference was detected between the groups in terms of functional or pain scores. There was no difference in complication rates between the groups. CONCLUSIONS:
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Authors | Charles Jordan, Roy I Davidovitch, Michael Walsh, Nirmal Tejwani, Andrew Rosenberg, Kenneth A Egol |
Journal | The Journal of bone and joint surgery. American volume
(J Bone Joint Surg Am)
Vol. 92
Issue 2
Pg. 368-74
(Feb 2010)
ISSN: 1535-1386 [Electronic] United States |
PMID | 20124064
(Publication Type: Comparative Study, Journal Article)
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Topics |
- Adult
- Anesthesia, General
- Anesthesia, Spinal
- Ankle Injuries
(epidemiology, surgery)
- Comorbidity
- Diabetes Mellitus
(epidemiology)
- Female
- Humans
- Male
- Middle Aged
- Multivariate Analysis
- Pain, Postoperative
(prevention & control)
- Recovery of Function
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