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Is It Safe to Prep the External Fixator In Situ During Second-Stage Pilon Surgical Treatment?
Paul J Nielsen1, Leonid S Grossman1, Justin C Siebler1
1Department of Orthopaedic Surgery and Rehabilitation, University of Nebraska Medical Center, Omaha, NE.
Objective:
To evaluate the infection rate of our protocol of prepping the external fixator in situ during definitive second-stage pilon fracture open reduction internal fixation.
Design:
Retrospective clinical investigation.
Setting:
Academic Level 1 Trauma Center.
Patients/Participants:
Out of 229 patients with distal tibia fractures presenting to our institution from 1999 to 2014, 100 were treated in a 2-stage fashion utilizing this protocol.
Intervention:
Prepping the external fixator into the surgical field during the second-stage/definitive open reduction internal fixation procedure.
Main Outcome Measurement:
The rates of deep and superficial infections after definitive fixation.
Results:
The deep infection rate was 13%, and the superficial infection rate was 11%.
Conclusions:
Infection rates using this protocol are comparable to previously reported infection rates for two-stage surgical treatment of pilon fractures. This protocol provides the treating surgeon information about an alternative method to streamline definitive fixation.
Level Of Evidence:
Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.
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