Risk factors for traumatic fracture related infection in surgically treated ankle fracture: A multicenter...

Infection after ankle fracture fixation is a serious complication, leading to a prolonged healing period and dysfunction in a long-term follow-up. Identifying risk factors for ankle fracture-related infection (FRI) is beneficial in preventing complications and reducing the risk of treatment. The study aims to retrospectively analyze clinical risk factors for ankle FRI.

A cross-sectional retrospective study of operatively treated ankle fractures was conducted at 2 medical centers from March 2020 to March 2023. Patients with open or pathological conditions were excluded, and 298 patients who underwent surgical treatment for ankle fractures were included. Risk factors of the patients who were diagnosed of FRI were analyzed using univariate analysis and binary logistic regression. Regression coefficients were used to calculate statistical probabilities of FRI.

Of the 298 patients, 21 (7.1%) were diagnosed infection. On univariate analysis, soft tissue bloody blisters (p=0.002) and ankle dislocation (p=0.001) were associated with a significantly higher incidence of infection. On binary logistic multifactorial regression analysis, the risk factors for FRI were ankle dislocation (p<0.001, odd ratio (OR)=11.799, 95% confidence interval (CI): 3.307-42.135), soft tissue bloody blisters (p=0.045, OR=8.004, 95% CI: 1.045-61.340), Langer-Hans typing pronation-abduction (p=0.033, OR=1.746, 95% CI: 1.183-27.766), and smoking (p=0.037, OR=4.948, 95% CI: 1.105-22.162).

The risk factors of FRI were soft tissue conditions including bloody blisters and ankle dislocation, when dealing with ankle fractures. The results of this study will inform surgeons and patients factors for the risk factors for FRI and guide surgeons in mitigate these risks preoperatively.