Complications

Introduction: Rerouting urine flow is often required following radical cystectomy (RC). In this context, the ileal conduit (IC) has become the most common technique for urinary diversion, primarily due to its technical simplicity and suitability for patients with compromised renal function, elderly individuals, and those unable to perform self-catheterization. Objective: This review aims to highlight the complications of IC and categorize them into metabolic and surgical complications, further subdivided by timing (intraoperative, short-term, intermediate-term, and long-term) and anatomical location (uretero-ileal anastomosis, stoma, and ileal segment). Methods: A comprehensive narrative review was conducted to summarize the most common complications of IC, their clinical presentation, and management using Google Scholar, PubMed, and Embase databases to identify studies published from 1950 to 2024. Results: The morbidity associated with IC, especially when compared to continent diversions, remains a subject of debate. Notably, IC-related complications have been described with an incidence rate ranging from 39% to 67%. Conclusions: Providing a comprehensive overview of IC complications and management strategies can enhance clinical practice and improve patient outcomes.

Ankle fractures are extremely common and often require surgical management, historically with open reduction and internal fixation (ORIF), although fibular intramedullary nailing (IMN) has demonstrated promising results in recent years. The purpose of this study is to report on risk factors, quality of reduction, and complications in a series of patients undergoing fibular IMN for management of ankle fractures using a novel device via a retrospective case series. Patients undergoing locked fibular IMN with the Flex-Thread nail (Conventus Flower Orthopedics, Horsham, PA, USA) by a single surgeon from January 2023 to March 2025 were included, with at least 6 months of follow-up. Demographics, comorbidities, injury characteristics, reduction quality, and post-operative complications were recorded. Descriptive analyses were reported for categorical variables. A total of 15 patients were included, with a mean age of 58.9 ± 22.0 (range 18–91) and mean BMI of 31.5 ± 5.7 kg/m². All patients experienced a fall as their mechanism of injury, with 12 Weber B and 3 Weber C fractures. The mean time to surgery from the date of injury was 9.5 ± 5.5 days. Of 15 patients, 66.7% had good reduction quality, 26.7% had fair, and 1 patient experienced poor reduction quality requiring subsequent hardware removal. There was one patient who experienced delayed wound healing. Patients undergoing fibular fixation using the novel Flex-Thread nail experience a fair to good quality of reduction, with limited complications. Both young and elderly patients have relatively positive early post-operative outcomes. Additional research with longer-term follow-up will be required to confirm its efficacy.

This study analyzed complication rates, perioperative metrics, and hospital readmissions across BMI cohorts in patients undergoing direct anterior approach (DAA) total hip arthroplasty (THA) in a mature hip practice. Currently, the precise BMI cutoff points for risk in THA are not fully understood. A retrospective review was conducted of patients who underwent DAA THA by a single, highly experienced, fellowship-trained surgeon between January 2021 and January 2023. The use of single-surgeon cases allows for control of many potentially confounding variables but may limit the generalizability of the findings. Data collected included patient demographics, hospital readmissions, 12-month complication rates, and intraoperative metrics. Patients with Class II obesity (BMI 35–39.9) kg/m² and Class I obesity (BMI 30–34.9) kg/m² had significantly higher intraoperative blood loss and longer operative times compared to the control group (BMI 20–24.9 kg/m²). No statistically significant differences in hospital readmission rates or complication rates were observed between BMI cohorts. Higher BMI was associated with increased intraoperative blood loss and longer operation time; however, no differences were found in hospital readmissions or complication rates between BMI cohorts.