Abstract
BackgroundSurgical site infection (SSI) was the most common complication of tibial plateau fracture after open reduction and internal fixation (ORIF). Severe infections even required repeat surgeries, which would cause serious psychological harm to patients and increased the economic burden of treatment. In order to identify the characteristics of the SSI and to avoid the occurrence of SSI, we conducted a prospective study to investigate the incidence and independent risk factors of SSI after ORIF for closed tibial plateau fractures in adults.MethodsThis study was performed at a first-level trauma center. From October 2014 to December 2018, the study subjects were adult patients with closed fractures of the tibial plateau, all of whom underwent open reduction and internal fixation (ORIF) treatment. Finally, a total of 1108 patients were followed up. We collected patient demographics information, surgery-related variables, and indexes from preoperative laboratory examinations. Univariate and multivariate logistic analysis models were used to investigate the potential risk factors.ResultsTwenty-five patients (2.3%, 25/1108) developed SSI. A total of 15 of 25 infections (60.0%) were due to Staphylococcus aureus and 3 (12.0%) were due to MRSA. Independent risk factors of SSI identified by multivariate logistic analysis model were bone grafting: autograft (OR 6.38; 95% CI 2.155–18.886; p = 0.001) and allograft (OR 3.215; 95% CI 1.009–10.247; p = 0.048), fracture type (Schartzker V–VI) (OR 8.129; 95% CI 2.961–22.319; p < 0.001), aspartate aminotransferase (>40 U/L) (OR 5.500; 95% CI 2.191–13.807; p < 0.001), white blood cell (>10*109/L) (OR 2.498; 95% CI 1.025–6.092; p = 0.044), and anion gap (>16 mmol/L) (OR 8.194; 95% CI 1.101–60.980).ConclusionsWe should pay enough attention to patients who carried one or more of these factors at admission and adopt more reasonable treatment strategies to reduce or avoid the occurrence of SSI.
Highlights
Tibial plateau fracture was one of the most common lower limb fractures in orthopedics, accounting for 36.5% of tibial and fibula fractures [1]
Exclusion criteria were under 18 years of age, open fractures, pathological fractures caused by other diseases, treatment with external fixation or conservative method, incomplete medical data, patients lost to follow-up, and fractures around the prosthesis after knee replacement
Characteristics of the study sample During the study interval, a total of 1384 patients with tibial plateau fracture were collected, 236 patients were excluded due to age less than 18 years (49), periprosthetic fracture (13), pathological fracture (14), open fracture (71), treatment with external fixation or conservative method (60), incomplete medical data (29), and patients lost to follow-up (40) (Fig. 1)
Summary
Tibial plateau fracture was one of the most common lower limb fractures in orthopedics, accounting for 36.5% of tibial and fibula fractures [1]. ORIF is the most common treatment choice, which aims at anatomical reduction of fractures and restoration of the lower limb force line. There were many potential complications of surgical treatment after tibial plateau fracture, including SSI, joint stiffness, traumatic osteoarthritis, delayed, or non-union [2,3,4]. It was important to understand the characteristics and associated risk factors of SSI to reduce this complication. Surgical site infection (SSI) was the most common complication of tibial plateau fracture after open reduction and internal fixation (ORIF). In order to identify the characteristics of the SSI and to avoid the occurrence of SSI, we conducted a prospective study to investigate the incidence and independent risk factors of SSI after ORIF for closed tibial plateau fractures in adults
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
