Implant Removal Due to Infection After Open Reduction and Internal Fixation: Trends and Predictors.

Area of Science:

• Orthopedic Surgery
• Infectious Disease
• Health Services Research

Background:

• Implant removal due to infection is a significant cause of failure in open reduction and internal fixation (ORIF) procedures.
• Understanding trends and predictors of infection-related implant removal is crucial for improving patient outcomes.

Purpose of the Study:

• To determine the trends and identify predictors of infection-related implant removal following ORIF of extremities.
• To analyze a nationally representative database for insights into infection-related implant removal.

Main Methods:

• Utilized Nationwide Inpatient Sample data from 2006 to 2017.
• Identified ORIF procedures for upper and lower extremity fractures and subsequent infection-related implant removals.
• Performed multivariate analysis to identify independent predictors, controlling for various patient and hospital factors.

Main Results:

• Highest infection-related implant removal rates were observed in phalanges/hand (5.61%), phalanges/foot (5.08%), and radius/ulna (4.85%).
• Tarsal/metatarsal and tibial fractures were independent predictors of removal. Male gender, obesity, diabetes with complications, and anemia were associated with increased removal rates.
• Infection-related implant removal incurred higher healthcare costs compared to non-infection related removals.

Conclusions:

• Infection-related implant removal rates decreased overall, except for radial/ulnar fractures.
• Diabetes, liver disease, and rheumatoid arthritis are significant predictors of infection-related implant removal.
• Identified risk factors like diabetes, obesity, and anemia warrant further investigation for targeted prevention strategies.