Incidence and Risk Factors for Acute Infection After Proximal Humeral Fractures: A Multicenter Study

Blonna, Davide; Prun, Nicola Barbasetti di; Bellato, Enrico; Massè, Alessandro; Battiston, Bruno; Castoldi, Filippo

doi:10.1016/j.jse.2014.06.022

Cited by 6 publications

(9 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…In prior research, olecranon osteotomy stabilized with a plate and screws was a risk factor for SSI [14], and plate and screw fixation also was found to be a risk factor for SSI in long bone fractures [29]. The data regarding SSI after plate and screw fixation of tibial plateau fractures, distal tibia fractures, proximal humerus fractures, and humeral shaft fractures are less consistent [5,8,12,15,16,23,26,30,33]. In the elbow, a higher rate of SSI in patients treated with plate and screw fixation might occur owing to the presence of implants directly underneath the wound, particularly if there is a suture abscess, wound separation, or wound edge necrosis.…”

Section: Discussionmentioning

confidence: 99%

What Factors are Associated With a Surgical Site Infection After Operative Treatment of an Elbow Fracture?

Claessen

Braun

Leeuwen

et al. 2016

Clinical Orthopaedics &Amp; Related Research

View full text Add to dashboard Cite

Background Surgical site infections are one of the more common major complications of elbow fracture surgery and can contribute to other adverse outcomes, prolonged hospital stays, and increased healthcare costs. Questions/purposes We asked: (1) What are the factors associated with a surgical site infection after elbow fracture surgery? (2) When taking the subset of closed elbow fractures only, what are the factors associated with a surgical site infection? (3) What are the common organisms isolated from an elbow infection after open treatment? Methods One thousand three hundred twenty adult patients underwent surgery for an elbow fracture between January 2002 and July 2014 and were included in our study. Forty-eight of 1320 patients (4%) had a surgical site infection develop. Thirty-four of 1113 patients with a closed fracture (3%) had a surgical site infection develop.Results For all elbow fractures, use of plate and screw fixation (adjusted odds ratio [OR]= 2.2; 95% CI, 1.0-4.5; p = 0.041) and use of external fixation before surgery (adjusted OR = 4.7; 95% CI, 1.1-21; p = 0.035) were associated with higher infection rates. When subset analysis was performed for closed fractures, only smoking (adjusted OR = 2.2; 95% CI, 1.1-4.5; p = 0.023) was associated with higher infection rates. Staphylococcus aureus was the most common bacteria cultured (59%). Conclusions The only modifiable risk factor for a surgical site infection after open reduction and internal fixation was cigarette smoking. Plate fixation and temporary external fixation are likely surrogates for more complex injuries, therefore no recommendations should be inferred from this association. Surgeons should counsel patients who smoke. Level of Evidence Level IV, prognostic study.

show abstract

Section: Discussionmentioning

confidence: 99%

What Factors are Associated With a Surgical Site Infection After Operative Treatment of an Elbow Fracture?

Claessen

Braun

Leeuwen

et al. 2016

Clinical Orthopaedics &Amp; Related Research

View full text Add to dashboard Cite

show abstract

“…A multicentre study in Italy assessed rates of infection in patients undergoing surgery for proximal humeral fracture repair [7]. Of the 452 patients assessed, 4% developed deep infection following surgery.…”

Section: Epidemiology Of Postsurgical Infectionmentioning

confidence: 99%

Trends in surgical site infections following orthopaedic surgery

Lamagni

Elgohari

Harrington

2015

Current Opinion in Infectious Diseases

View full text Add to dashboard Cite

Prevention of orthopaedic infection is dependent on elimination or optimal management of documented risk factors. Guidelines and quality standards play a key role in translating this evidence base into a framework of practices for the prevention of surgical site infections. Increasing levels of orthopaedic infection due to Enterobacteriaceae, coupled with an increasingly obese surgical population may necessitate a reassessment of antimicrobial prophylaxis strategies.

show abstract

“…The association between low-grade infection caused mostly by Cutibacterium acnes and a painful stiff shoulder is increasingly identified not only in patients undergoing shoulder arthroplasty but also shoulder arthroscopy [9,11,12]. Only few articles have been published dealing with infection after proximal humerus osteosynthesis and all of them are reporting only about acute postoperative infections [13,14]. To our knowledge there is no data regarding the microbiologic profile of possible infections at the time of revision surgery without robust signs of infection after osteosynthesis of proximal humerus.…”

Section: Introductionmentioning

confidence: 99%

High rate of unexpected positive cultures in presumed aseptic revision of stiff shoulders after proximal humerus osteosynthesis

Akgün¹,

Peters²,

Maziak³

et al. 2020

BMC Musculoskelet Disord

View full text Add to dashboard Cite

Background: The aim of this study was to investigate the prevalence of positive microbiology samples after osteosynthesis of proximal humerus fractures at the time of revision surgery and evaluate clinical characteristics of patients with positive culture results. Methods: All patients, who underwent revision surgery after locked platting, medullary nailing or screw osteosynthesis of proximal humeral fractures between April 2013 and July 2018 were retrospectively evaluated. Patients with acute postoperative infections, those with apparent clinical signs of infection and those with ≤1 tissue or only sonication sample obtained at the time of implant removal were excluded. Positive culture results of revision surgery and its correlation with postoperative shoulder stiffness was analyzed in patients with an interval of ≥6 months between the index osteosynthesis and revision surgery. Results: Intraoperatively obtained cultures were positive in 31 patients (50%). Cutibacterium acnes was the most commonly isolated microorganism, observed in 21 patients (67.7%), followed by coagulase negative staphylococci in 12 patients (38.7%). There were significantly more stiff patients in the culture positive group compared to the culturenegative group (19/21, 91% vs. 15/26, 58%, p = 0.02). Furthermore, 11 of 12 (91.7%) patients with growth of the same microorganism in at least two samples had a stiff shoulder compared to 23 of 35 (65.7%) patients with only one positive culture or negative culture results (p = 0.14). Conclusion: Infection must always be considered as a possibility in the setting of revision surgery after proximal humerus osteosynthesis, especially in patients with postoperative stiffness.

show abstract

Incidence and Risk Factors for Acute Infection After Proximal Humeral Fractures: A Multicenter Study

Cited by 6 publications

References 0 publications

What Factors are Associated With a Surgical Site Infection After Operative Treatment of an Elbow Fracture?

What Factors are Associated With a Surgical Site Infection After Operative Treatment of an Elbow Fracture?

Trends in surgical site infections following orthopaedic surgery

High rate of unexpected positive cultures in presumed aseptic revision of stiff shoulders after proximal humerus osteosynthesis

Contact Info

Product

Resources

About