Topical Antibiotics in Ankle Fractures Study

TAAFS Operation Report Template:

**Template only - clinicians to edit for individual patient. Check for "**" to edit appropriately**

() Side Ankle ORIF (Smith & Nephew Evos System/Synthes Universal Small Frag System/Stryker VariAx System)**

--TAAFS Study Patient--

Study medication bag given = XX

C:

S:

A:

Findings:

Closed/GX Gustilo-Anderson Open Fracture**

Weber X **

Uni/Bi/Tri-malleolar # **

Syndesmosis Un/stable**

Procedure:

GA

Supine

Tourniquet**

Prep and drape

--

Lateral side

Lateral approach to fibula/Posterolateral approach to fibula**

Superficial peroneal nerve identified and protected

Periosteum incised and reflected

Fracture debrided and reduced

X-Hole 1/3 Tubular plate sized and inserted**

X x 3.5mm cortical and X x 4mm cancellous screws inserted**

--

--

Posterior malleolus

Posterolateral approach to tibia

FHL elevated

Fracture identified, debrided and reduced under II vision

X-Hole posterior malleolus contoured plate sized and inserted in buttress configuration

X x 3.5mm cortical non-locking and X x 3.5mm locking screws inserted**

--

--

Medial side

Direct medial approach to medial malleolus

Saphenous nerve and vein protected

Fracture debrided and reduced

2x 45mm partially threaded cancellous screws inserted**

--

--

Syndesmosis stressed/open syndesmotic inspection/arthroscopic inspection**

Single large frag transyndesmotic screw inserted w/ reduction forceps applied in dorsiflexion to reduce syndesmosis**

Syndesmotic tightrope inserted w/ reduction forceps applied in dorsiflexion to reduce syndesmosis**

--

Final II shots acceptable

Wash

Layered closure 2-0, 3-0 vicryl**

Nylon/Monocryl 4-0 to skin**

Prineo/Primapore/Mepitel Border**

Moonboot/SL POP**

Postop:

Routine obs

Elevation & ice packs

Analgesia - regular multimodals + PRN's

Antibiotics - IV AB's overnight**

Anti-coagulation - Aspirin/clexane 6/52**

Movement & ROM - Commence gentle AROM ex's out of boot from D1 to prevent stiffness

Weight Bearing - NWB 6/52**

Follow-up:

--All Follow-up visits to be done in the weekly TAAFS research clinic. Clinicians to use the Microsoft Teams app to enter in all data--

TAAFS Study clinic for wound r/v @ 2/52 for ROS

TAAFS Study clinic for 6/52 XOA + wound r/v - progress to WBAT in boot**

TAAFS Study clinic for 3/12 XOA + wound r/v - progress to WBAT

TAAFS Telehealth R/V @ 6/12 and 1yr postop

Notify concerns

Dr XX**

Orthopaedic Surgeon/Registrar**