Patient Demographics and Risk Factors for Surgical Site Infections After Open Reduction and Internal Fixation for...

Area of Science:

• Orthopedic Surgery
• Infectious Disease Epidemiology
• Surgical Outcomes Research

Background:

• Bimalleolar ankle fractures represent a significant portion (15-20%) of all ankle fractures.
• Surgical site infections (SSI) following open reduction and internal fixation (ORIF) of ankle fractures have a reported incidence of 4.37%.
• Limited data exists on specific risk factors for SSI after ORIF for bimalleolar ankle fractures.

Purpose of the Study:

• To determine the incidence of surgical site infection (SSI) after open reduction and internal fixation (ORIF) of bimalleolar ankle fractures.
• To identify patient-specific risk factors associated with the development of SSI in this surgical population.

Main Methods:

• Retrospective cohort study utilizing the PearlDiver Mariner Database.
• Inclusion of patients who underwent bimalleolar ankle fracture repair between January 1, 2010, and December 31, 2021.
• Comparative analysis of demographics and comorbidities between SSI and non-SSI groups using chi-square and multivariate logistic regression.

Main Results:

• The overall incidence of SSI after ORIF for bimalleolar ankle fractures was 3.1%.
• Significant risk factors for SSI included male sex, chronic kidney disease, diabetes, drug abuse, fluid/electrolyte disorders, hypertension, peripheral vascular disease, tobacco use, and weight loss.
• Peripheral vascular disease emerged as the strongest predictor of SSI development (OR = 1.62).

Conclusions:

• Preoperative risk stratification and patient optimization are crucial for minimizing SSI incidence in patients undergoing ORIF for bimalleolar ankle fractures.
• This study provides the first comprehensive delineation of SSI risk factors specific to this fracture type.
• Findings can guide clinical counseling to mitigate postoperative infection risks.