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Open Ankle Fractures: What Predicts Infection? A Multicenter Study.

Margaret E Cooke1, Paul Tornetta2, Reza Firoozabadi3

  • 1Department of Orthopaedic Surgery, Stanford University School of Medicine, Stanford, CA.

Journal of Orthopaedic Trauma
|October 29, 2021
PubMed
Summary
This summary is machine-generated.

Infection after open ankle fractures is common, affecting 15% of patients. Male sex, diabetes, smoking, and delayed wound closure increase infection risk, leading to poorer outcomes.

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Area of Science:

  • Orthopedic Surgery
  • Trauma Care
  • Infectious Diseases

Background:

  • Open ankle fractures are complex injuries requiring careful management.
  • Infection is a significant complication that can negatively impact treatment outcomes.

Purpose of the Study:

  • To identify patient, injury, and treatment factors linked to acute infection in open ankle fractures.
  • To assess the impact of infectious complications on nonunion, malunion, and loss of reduction rates.

Main Methods:

  • A multicenter retrospective review involving 1003 consecutive patients with open ankle fractures.
  • Data collected from 16 trauma centers.
  • Analysis focused on fracture-related infection (FRI) and associated outcomes.

Main Results:

  • The overall FRI rate was 15% among 712 eligible patients.
  • Independent risk factors for FRI included male sex, diabetes, smoking, immunosuppressant use, delayed wound closure, and wound location.
  • Infection was significantly associated with increased rates of malunion, nonunion, loss of reduction, and/or implant failure (P = 0.01).

Conclusions:

  • Several modifiable and non-modifiable factors contribute to the risk of fracture-related infection in open ankle fractures.
  • Infectious complications are linked to adverse structural and functional outcomes, underscoring the importance of infection prevention.