双骨骨折の開いた縮小と内部固定後の手術部位感染症の患者統計とリスク要因
Paul G Mastrokostas1, Arie Monas, Ariel N Rodriguez
1From the Department of Orthopaedic Surgery (Mastrokostas, and Monas), SUNY Downstate Health Sciences University, and the Maimonides Medical Center (Mastrokostas, Rodriguez, Lam, Razi, and Ng), Department of Orthopaedic Surgery, Brooklyn, NY.
The Journal of the American Academy of Orthopaedic Surgeons
|September 4, 2025
まとめ
手術部位感染 (SSI) は,双骨骨折の修復後の患者の3. 1%で発生する. 主要なリスク要因は男性性,糖尿病,外周血管疾患で,手術前のリスク評価の必要性を強調しています.
科学分野:
- 整形 術
- 感染症 疫学
- 手術 結果 研究
背景:
- 足首の骨折は,すべての足首の骨折の重要な部分 (15-20%) を占めています.
- 足首骨折のオープン・リダクションと内部固定 (ORIF) の後の手術部位感染 (SSI) の発生率は4. 37%と報告されています.
- 双葉足首骨折のORIF後のSSIの特定の危険因子に関するデータは限られている.
研究 の 目的:
- 双骨骨折のオープン・リダクションと内部固定 (ORIF) の後の手術部位感染 (SSI) の発生率を決定する.
- この手術群でSSIの発生に伴う患者特有の危険因子を特定する.
主な方法:
- パールダイバー・マリナー・データベースを利用した遡及的なコホート研究.
- 2010年1月1日から2021年12月31日までの間,双軸足首骨折の修復を受けた患者を含む.
- 千二乗と多変数論理回帰を用いたSSI群と非SSI群の人口統計と併発症の比較分析
主要な成果:
- 双葉足首骨折におけるORIF後のSSIの総発生率は3. 1%であった.
- SSIの重要な危険因子には,男性性,慢性腎疾患,糖尿病,薬物乱用,液体/電解質障害,高血圧,外周血管疾患,喫煙,体重減少が含まれています.
- 外周血管疾患は,SSI発症の最も強い予測因子 (OR=1. 62) であった.
結論:
- 手術前リスクの階層化と患者の最適化は,双葉足首骨折でORIFを受ける患者のSSI発生率を最小限に抑えるために不可欠です.
- この研究は,この骨折タイプに特有のSSIリスク因子の最初の包括的な描写を提供します.
- 手術後の感染リスクを軽減するための臨床カウンセリングの指針となる.
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