Risk Factors for Infection and Subsequent Adverse Clinical Results in the Setting of Operatively Treated Pilon...

Area of Science:

• Orthopedic Surgery
• Trauma Surgery
• Infectious Disease

Background:

• Tibial pilon fractures are severe injuries requiring operative fixation.
• Fracture-related infections (FRIs) and adverse outcomes are significant complications.
• Predicting these complications is crucial for patient management.

Purpose of the Study:

• To identify patient-specific and injury-specific factors predicting infection and adverse outcomes in tibial pilon fractures.
• To analyze risk factors for developing fracture-related infections.
• To determine predictors of poor clinical results post-operatively.

Main Methods:

• Retrospective chart review of 248 patients undergoing operative treatment for tibial pilon fractures (2010-2020).
• Analysis of external fixation and/or open reduction and internal fixation interventions.
• Evaluation of fracture-related infection rates, bacteriology, and clinical outcomes.

Main Results:

• Overall infection rate was 21%.
• Diabetes mellitus, open fractures, and comminuted fractures (OTA/AO 43C2/43C3) were associated with higher infection risk.
• Polymicrobial infections and history of diabetes predicted adverse clinical results.

Conclusions:

• Diabetes and severe fracture characteristics (open, comminuted) predict fracture-related infections after operative tibial pilon fracture fixation.
• Diabetes history and polymicrobial infections are independently associated with adverse clinical outcomes.