Risk factors for infection after operative fixation of Tibial plateau fractures

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• 作者：Amit M. Momaya ; Jimmy Hlavacek ; Brian Etier ; David Johannesmeyer ; Lasun O. Oladeji ; Thomas E. Niemeier ; Nicholas Herrera ; Jason A. Lowe ; ^{jlowe1069@gmail.com" class="auth_mail" title="E-mail the corresponding author}
• 关键词：Tibial plateau fracture ; Infection ; Complications ; Open reduction ; Internal fixation
• 刊名：Injury
• 出版年：2016
• 出版时间：July 2016
• 年：2016
• 卷：47
• 期：7
• 页码：1501-1505
• 全文大小：248 K

文摘

Tibial plateau fractures are challenging to treat due to the high incidence of postoperative infections. Treating physicians should be aware of risk factors for postoperative infection in patients who undergo operative fixation.

Patients and methods

A retrospective review was undertaken to identify all patients with tibial plateau fractures over a 10 year period (2003–2012) who underwent open reduction internal fixation. A total of 532 patients were identified who met the inclusion criteria. Several patient and clinical characteristics were recorded, and those variables with a significant association (p < 0.05) with postoperative infection after a univariate analysis were further analyzed using a multivariate analysis.

Results

Fifty-nine (11.1%) of the 532 patients developed a deep infection. The average length of follow-up for patients was 19.5 months. Methicillin-resistant Staphylococcus aureus was the most common species, and it was isolated in 26 (44.1%) patients. Open fractures, the presence of compartment syndrome, and a Schatzker type IV−VI were found to be independent risk factors for deep infection.

Conclusions

The rate of deep infection remains high after operative fixation of tibial plateau fractures. Patients with risk factors for infection should be counseled on the possibility of reoperation, and surgeons should consider MRSA prophylaxis in those patients who are at higher risk.