Factors affecting infection after calcaneal fracture fixation

Court-Brown, Charles M.; Schmidt, Matthias; Schutte, Bernard G.

doi:10.1016/j.injury.2009.03.044

Cited by 79 publications

(75 citation statements)

References 16 publications

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“…Factors that were associated with an increased risk for wound infections were ASA classification other than 1 and absence of a closed suction drain placement at the end of surgery. None of the previously reported risk factors (higher BMI, drug abuse, smoking, outpatient management and surgery after more than five or 14 days) showed a relation with a post-operative wound infection in our study [5,12,20,21] (Table 3). As there was no difference in wound infections between pre-operative in-or outpatients we find that pre-operative outpatient management is acceptable.…”

Section: Discussionmentioning

confidence: 42%

“…Patients with open fractures and/or treatment with an external fixator prior to ORIF were excluded because of the increased risk of post-operative wound complications [9,11,12]. Patients with bilateral calcaneal fractures were excluded because of the unfeasibility of performing an independent analysis of two fractures in the same patient.…”

Section: Methodsmentioning

confidence: 99%

“…The incidence of a wound infection following operative treatment of closed calcaneal fractures varies between 2 % and 25 % and rates of complications requiring surgery are up to 21 % [5][6][7][8][9][10][11][12][13][14][15][16][17][18][19] (Table 1).…”

Section: Introductionmentioning

confidence: 99%

“…Some studies identified covariates associated with an increased risk of wound complications such as a higher body mass index (BMI), smoking [5,20] and drug abuse [12]. In addition, the incidence of wound infections increased in patients who were managed as outpatients pre-operatively or underwent surgery more than five or 14 days following trauma [5,20,21].…”

Section: Introductionmentioning

confidence: 99%

“…However, another recent retrospective study showed no correlation with surgical timing [22]. Intra-operative risk factors were surgical experience [12,23] and a single layered closure technique [20].…”

Section: Introductionmentioning

confidence: 99%

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Wound infections following open reduction and internal fixation of calcaneal fractures with an extended lateral approach

Backes

Schepers

Beerekamp

et al. 2013

International Orthopaedics (SICOT)

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Purpose Post-operative wound infections (PWI) following calcaneal fracture surgery can lead to prolonged hospital stay and additional treatment with antibiotics, surgical debridement or implant removal. Our aim was to determine the incidence of superficial and deep PWI and to identify risk factors (RF). Methods This study is a retrospective case series. All consecutive patients from 2000 to 2010 with a closed unilateral calcaneal fracture treated with open reduction and internal fixation (ORIF) by an extended lateral approach were included. Patient, fracture, trauma and peri-operative characteristics were collected, including RF such as smoking, diabetes mellitus, time to operation, pre-operative in-or outpatient management and wound closure technique. The primary end point was a PWI as defined by the US Centers for Disease Control and Prevention. Results A total of 191 patients were included of which 47 patients (24.6 %) had a PWI; 21 (11.0 %) and 26 (13.6 %) patients had a superficial and deep wound infection, respectively. American Society of Anesthesiologists (ASA) classification higher than ASA 1 was associated with an increased risk. Placement of a closed suction drain at the end of surgery was associated with less PWI (35 % vs 15 %, p =0.002). In this study, none of the previously reported RF were associated with an increased risk for PWI. Conclusions ORIF of displaced calcaneal fractures is associated with a high rate of PWI of 25 %. Factors that were associated with an increased risk were ASA classification other than 1 and absence of a closed suction drain placement.A closed suction drain may be a protective measure to avoid wound complications.

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Section: Discussionmentioning

confidence: 42%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Wound infections following open reduction and internal fixation of calcaneal fractures with an extended lateral approach

Backes

Schepers

Beerekamp

et al. 2013

International Orthopaedics (SICOT)

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Knochen: Frakturen, Stressreaktionen und Fehlverheilungen

Zwipp

Rammelt

2014

Tscherne Unfallchirurgie

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The sinus tarsi approach in displaced intra-articular calcaneal fractures: a systematic review

Schepers

2011

International Orthopaedics (SICOT)

144

114

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PurposeAlthough open reduction and internal fixation is currently considered the gold standard in surgical treatment of displaced intra-articular calcaneal fractures, various different approaches exist including the limited lateral approach. The aim of this systematic review was to combine the results of studies using the sinus tarsi approach, which is the most frequently applied limited lateral approach.MethodA literature search in the electronic databases of the Cochrane Library and Pubmed Medline, between January 1st 2000 to December 1st 2010, was conducted to identify studies in which the sinus tarsi approach or a modified sinus tarsi approach was utilized for the treatment of displaced intra-articular calcaneal fractures. The methodological quality of the included studies was assessed using the Coleman methodology score.ResultsA total of eight case series reporting on 256 patients with 271 calcaneal fractures was identified. Overall good to excellent outcome was reached in three-quarters of all patients. An average complication rate of minor wound complications of 4.1% was reported and major wound complications in 0.7%. The need for a secondary subtalar arthrodesis occurred at an average rate of 4.3%. The average Coleman methodology score was 56.8 (range 39–72) points.ConclusionThe results, i.e. functional outcome and complication rates, of the sinus tarsi approach compare similarly or favourably to the extended lateral approach. Therefore, in the process of tailoring the best treatment modality to the right patient and the right fracture type, the sinus tarsi approach might be a valuable asset.

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Factors affecting infection after calcaneal fracture fixation

Cited by 79 publications

References 16 publications

Wound infections following open reduction and internal fixation of calcaneal fractures with an extended lateral approach

Wound infections following open reduction and internal fixation of calcaneal fractures with an extended lateral approach

Knochen: Frakturen, Stressreaktionen und Fehlverheilungen

The sinus tarsi approach in displaced intra-articular calcaneal fractures: a systematic review

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