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European Journal of Orthopaedic Surgery & Traumatology

Published in:

01-07-2014 | Original Article

Surgical site infection after open reduction and internal fixation of tibial plateau fractures

Authors: Shishui Lin, Cyril Mauffrey, E. Mark Hammerberg, Philip F. Stahel, David J. Hak

Published in: European Journal of Orthopaedic Surgery & Traumatology | Issue 5/2014

Abstract

Objective

The aim of this study was to identify risk factors for surgical site infections and to quantify the contribution of independent risk factors to the probability of developing infection after definitive fixation of tibial plateau fractures in adult patients.

Methods

A retrospective analysis was performed at a level I trauma center between January 2004 and December 2010. Data were collected from a review of the patient’s electronic medical records. A total of 251 consecutive patients (256 cases) were divided into two groups, those with surgical site infections and those without surgical site infections. Preoperative and perioperative variables were compared between these groups, and risk factors were determined by univariate analyses and multivariate logistic regression. Variables analyzed included age, gender, smoking history, diabetes, presence of an open fracture, presence of compartment syndrome, Schatzker classification, polytrauma status, ICU stay, time from injury to surgery, use of temporary external fixation, surgical approach, surgical fixation, operative time, and use of a drain.

Results

The overall rate of surgical site infection after ORIF of tibial plateau fractures during the 7 years of this study was 7.8 % (20 of 256). The most common causative pathogens was Staphylococcus aureus (n = 15, 75 %). Independent predictors of surgical site infection identified by multivariate analyses were open tibial plateau fracture (odds ratio = 3.9; 95 % CI = 1.3–11.6; p = 0.015) and operative time (odds ratio = 2.7; 95 % CI = 1.6–4.4; p < 0.001). The presence of compartment syndrome (odds ratio = 3.4; 95 % CI = 0.7–15.9; p = 0.119), use of temporary external fixation (odds ratio = 0.5; 95 % CI = 0.2–1.7; p = 0.298), and ICU stay (odds ratio = 1.0; 95 % CI = 1.0–1.1; p = 0.074) were not determined to be independent predictors of surgical site infection.

Conclusions

Both open fracture and operative time are independent risks factors for postoperative infection.

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Title: Surgical site infection after open reduction and internal fixation of tibial plateau fractures
Authors: Shishui Lin
Cyril Mauffrey
E. Mark Hammerberg
Philip F. Stahel
David J. Hak
Publication date: 01-07-2014
Publisher: Springer Paris
Published in: European Journal of Orthopaedic Surgery & Traumatology / Issue 5/2014
Print ISSN: 1633-8065
Electronic ISSN: 1432-1068
DOI: https://doi.org/10.1007/s00590-013-1252-8

At a glance: The STEP trials

Springer Medicine

Surgical site infection after open reduction and internal fixation of tibial plateau fractures

Abstract

Objective

Methods

Results

Conclusions

At a glance: The STEP trials

Springer Medicine

Abstract

Objective

Methods

Results

Conclusions

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