Abstract
Category:
Ankle; Basic Sciences/Biologics; Hindfoot; Midfoot/Forefoot; Trauma; Other
Introduction/Purpose:
The management of postoperative soft tissue healing is fundamental for the success of elective foot and ankle surgery. As postoperative edema is more relevant in such surgery due to its localization, soft tissue healing can take longer and pain can restrict function. There is no universal approach to surgery aftercare among foot and ankle surgeons. Although infections following foot and ankle surgery are rare, soft tissue healing can be jeopardized after extensive and multiple approaches. Postoperative edema, however, is common and contributes to unfavorable conditions for wound healing. Our study addresses the results of avoiding postoperative edema with the use of the Jones dressing cast.
Methods:
We defined a precise fixation technique of the foot and ankle in the immediate post-operative phase using what we call ‘the Jones dressing cast’. This technique is a modification of the Jones dressing bandage. In a previous study we compared two groups of patients (N = 20/23) who underwent similar reconstructive surgery with the application of the described cast for one week and without. At the twomonth follow-up we observed that the group treated with the cast required less pain relief, spent less time in hospital and achieved faster autonomy using crutches (Gottlieb and Klaue, 2013). In this study we considered a group of 45 patients who underwent similar reconstructive procedures to those in the first study and who were treated with the cast for two weeks post-operatively. There was no visual check of the soft tissues before removal of the cast.
Results:
Although patients in Group 2 had more complex surgery, mobility was achieved earlier and hospitalization time was shorter. The incidence of infection was lower in the group wearing the cast for 2 weeks. The patients treated with the cast for 2 weeks regained autonomous mobility significantly earlier than those in Group 1 (cast 1 week or less).
Conclusion:
The Jones dressing cast is a useful tool that can help minimize postoperative complication rates. Wearing the cast for two weeks is preferable. Our study suggests its effectiveness in reducing soft tissue complications and facilitating independent mobility.