Operative Risk Factors and Microbiologic Profiles of Deep Infection Following Pilon Fracture Fixation

Area of Science:

• Orthopedic Surgery
• Infectious Disease
• Trauma Care

Background:

• Deep tissue infection is a significant complication after operative fixation of pilon fractures.
• Intraoperative factors and microbial characteristics influencing these infections are not well understood.

Purpose of the Study:

• To investigate demographic, injury-related, operative, and microbiologic variables associated with deep infection following pilon fracture fixation.
• To identify risk factors for deep infection and its outcomes.

Main Methods:

• Retrospective review of 123 patients undergoing open reduction and internal fixation for pilon fractures.
• Analysis of patient demographics, injury characteristics, surgical details, and microbiological data.
• Statistical evaluation to identify variables associated with deep infection.

Main Results:

• Nine patients (7.3%) developed deep infections.
• Infected patients had longer operative times, but this was not an independent risk factor after covariate adjustment.
• Common pathogens included Pseudomonas aeruginosa, Enterococcus faecalis, Staphylococcus aureus, and Enterobacter cloacae.
• Deep infections led to high rates of nonunion (67%), post-traumatic osteoarthritis (44%), and amputation (33%).

Conclusions:

• Operative duration may not be an independent predictor of deep infection risk in pilon fractures.
• Larger studies are required to confirm these findings.
• Deep infections following pilon fracture fixation have severe consequences, necessitating further research into prevention and management strategies.