Incidence of Infection in Operatively Treated Distal Radius Fractures After Conversion From External to Internal...

Area of Science:

• Orthopedic surgery
• Trauma surgery
• Infectious disease epidemiology

Background:

• Distal radius fractures are common injuries.
• External fixation (EF) followed by internal fixation (IF) is a treatment strategy.
• Infection is a potential complication of fracture fixation.

Purpose of the Study:

• To determine the infection rate after EF to IF conversion for distal radius fractures.
• To investigate factors influencing infection risk, including timing of conversion and hardware placement.

Main Methods:

• Retrospective review of 64 distal radius fractures in 61 patients (≥18 years) from 2006-2019.
• Inclusion criteria: initial EF, subsequent IF, ≥10 weeks follow-up, no prior surgery or infection.
• Infection defined by positive cultures or re-operation for debridement.

Main Results:

• Overall infection incidence was 6 of 64 fractures (9.4%).
• Higher infection rates were observed with EF to IF conversion >14 days (2/5 patients) compared to ≤14 days (4/59 patients).
• Hardware overlap of EF pin sites did not significantly alter infection rates (3/27 vs 3/37).

Conclusions:

• Infection occurred in 9.4% of distal radius fractures after EF to IF conversion.
• Delayed conversion (>14 days) from EF to IF is associated with a higher risk of post-operative infection.