Prediction of infection following internal fixation of closed fractures by serum inflammatory factors

Abstract

Objective To explore the role of serum inflammatory factors in prediction of infection following internal fixation of closed fractures and its significance for surgical timing and infection prophylaxis. Methods A retrospective study was conducted of the 100 patients who had been treated by internal fixation for closed fracture from January 2014 through July 2016. They were 52 men and 48 women, aged from 24 to 76 years (average, 45 years). There were 14 femoral fractures, 19 tibial plateau fractures, 25 patella fractures, 8 pilon fractures, 22 tibiofibular shaft fractures, and 12 calcaneal fractures. Of them, 21 were inflicted by wound infection. The preoperative and postoperative infection indexes, CRP, ESR, PCT and leukocyte count, were recorded. Logistic regression analysis was conducted to test the correlation between the infection indexes and postoperative infection. The optimal cut-off value was determined by the receiver operating characteristic curve. Results CRP showed a significant correlation with postoperative infection while other indexes did not. The optimal cut-off value was 25 mg/L at one day before operation. Conclusions Preoperative determination of CRP may predict the risk of postoperative infection. CRP>25 mg/L at one day before operation may indicate the following day is not suitable for surgery and active infection prophylaxis should be conducted after surgery. Key words: Prediction; Fractures, closed; Infection; Serum inflammatory factors