Tyler James Moon1, Lucas Haase2, Douglas Haase3, George Ochenjele2, Brent Wise3, Joshua Napora2. 1. Department of Orthopedic Surgery, University Hospitals Cleveland Medical Center, 11100 Euclid Ave, Cleveland, OH, 44106, USA. tyler.moon@uhhospitals.org. 2. Department of Orthopedic Surgery, University Hospitals Cleveland Medical Center, 11100 Euclid Ave, Cleveland, OH, 44106, USA. 3. Department of Orthopedic Surgery, University of Kansas Medical Center, Kansas City, KA, USA.
Abstract
PURPOSE: Surgical trauma may confer additional infectious risk after operative fixation for high energy tibial plateau fractures. This study aims to determine the impact of plate number and location on infection rates after these injuries. METHODS: This retrospective cohort study completed at two level one trauma centers included patients who underwent staged fixation for a tibial plateau fracture between 2015 and 2019. Plate number and location (lateral, medial, posteromedial, and anterior quadrants) used in the definitive fixation construct were collected from post-operative radiographs. Deep infection rate was primary the outcome. RESULTS: A total of 244 patients met inclusion criteria. The overall infection rate was 13.9% (34/244). Infection rates increased with each additional quadrant utilized (8.0% one quadrant, 13.0% two quadrants, 27.3% three quadrants, 100% four quadrants; p < 0.001), independent of plate number, fracture severity, operative time, number of incisions, external fixator pin and plate construct overlap, and days in the external fixator on multivariate analysis. CONCLUSIONS: Infection risk increases with each quadrant utilized in the fixation of high energy tibial plateau fractures. Providers should attempt to limit the dissection of soft tissue for hardware placement in the fixation of these injuries to limit infection risk. LEVEL OF EVIDENCE: Level III, retrospective therapeutic study.
PURPOSE: Surgical trauma may confer additional infectious risk after operative fixation for high energy tibial plateau fractures. This study aims to determine the impact of plate number and location on infection rates after these injuries. METHODS: This retrospective cohort study completed at two level one trauma centers included patients who underwent staged fixation for a tibial plateau fracture between 2015 and 2019. Plate number and location (lateral, medial, posteromedial, and anterior quadrants) used in the definitive fixation construct were collected from post-operative radiographs. Deep infection rate was primary the outcome. RESULTS: A total of 244 patients met inclusion criteria. The overall infection rate was 13.9% (34/244). Infection rates increased with each additional quadrant utilized (8.0% one quadrant, 13.0% two quadrants, 27.3% three quadrants, 100% four quadrants; p < 0.001), independent of plate number, fracture severity, operative time, number of incisions, external fixator pin and plate construct overlap, and days in the external fixator on multivariate analysis. CONCLUSIONS: Infection risk increases with each quadrant utilized in the fixation of high energy tibial plateau fractures. Providers should attempt to limit the dissection of soft tissue for hardware placement in the fixation of these injuries to limit infection risk. LEVEL OF EVIDENCE: Level III, retrospective therapeutic study.
Authors: David P Barei; Sean E Nork; William J Mills; M Bradford Henley; Stephen K Benirschke Journal: J Orthop Trauma Date: 2004 Nov-Dec Impact factor: 2.512
Authors: Brent J Morris; R Zackary Unger; Kristin R Archer; Shannon L Mathis; Aaron M Perdue; William T Obremskey Journal: J Orthop Trauma Date: 2013-09 Impact factor: 2.512