Are Infection Rates Increased After Sterilization of the External Fixator During Staged Internal Fixation of High-Energy Tibial Plateau Fractures?. Issue 10 (October 2022)

• Record Type: Journal Article
• Authors: Moon, Tyler James; Haase, Lucas; Haase, Douglas; Ochenjele, George; Wise, Brent; Napora, Joshua
• Is Part Of: Journal of orthopaedic trauma. Volume 36:Issue 10(2022)
• Page Start: 530
• Page End: 534
• Publication Date: 2022-10
• Subjects: tibial plateau -- infection -- sterilization -- external fixation -- staged management; Orthopedics -- Periodicals; Wounds and injuries -- Periodicals; Orthopedics -- Periodicals; Wounds and Injuries -- therapy -- Periodicals; Periodicals; 617.47044
• DOI: 10.1097/BOT.0000000000002371
• Languages: English
• ISSNs: 0890-5339

Abstract

Abstract : Objectives: To compare infection rates after second-stage definitive surgery for high-energy tibial plateau fractures between groups of patients who had the external fixator prepped into the surgical field and those who did not. Design: Retrospective cohort study. Setting: Two academic Level 1 trauma centers. Patients/Participants: Two hundred forty-four patients met inclusion and exclusion criteria between the 2 institutions. Intervention: Prepping of the external fixator into the surgical field during second-stage definitive open reduction and internal fixation. 162 patients were in the prepped group, and 82 patients were in the nonprepped group. Main Outcome Measurements: The primary outcome was the rate of deep infection after definitive fixation. Secondary outcome was operative time. Results: There were no significant differences in infection rates between prepped (11.7%) and nonprepped (18.3%) groups ( P = 0.162). Patients in the prepped groups had significantly decreased operative time (168.2 minutes vs. 221.9 minutes, P < 0.001) even after controlling for confounders in regression analysis. Conclusions: There is no increased risk of infection associated with prepping and maintenance of the external fixator during definitive internal fixation for high-energy tibial plateau fractures. These data suggest that this practice may lead to shorter operative times as well. Level of Evidence: Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.