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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
Summary
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.
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.
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