Risk factors for infection in fixation of distal tibia fractures

Toro-Aguilera, Álvaro; Zuriarrain, Sara Wahab; Masdeu, Mireia Gómez; Sayol, R. Rojas; Billi, Angelica Millán; Carrera, Ion; Caso, J. De

doi:10.1016/j.injury.2021.02.085

Cited by 7 publications

(6 citation statements)

References 19 publications

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“…Therefore, infections and skin problems are common. After fractures of this region, soft tissue problems and infections are seen at a general rate of 6-37% [ 11 ]. In order to overcome this problem, minimally invasive methods are being developed to avoid damage to the soft tissues with additional dissection in surgery [ 12 ].…”

Section: Discussionmentioning

confidence: 99%

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Comparison of Open Reduction and Internal Fixation With Minimally Invasive Plating in the Treatment of Distal Tibial Fractures: A Retrospective Study

Akdemir¹,

Turan²,

Türken³

et al. 2022

Cureus

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IntroductionTreatment of distal tibial fractures may be problematic due to their close proximity to the ankle joint and poor skin coverage, resulting in skin problems, deep infection, and malunion. To address these problems, minimally invasive plating methods have been described. In this study, we aimed to compare the clinical findings, radiological findings, and complication rates of patients treated with open reduction or minimally invasive plating. MethodsA total of 44 patients with distal tibial fractures with a mean follow-up period of 20.73 (12-50) months were included in this study retrospectively. The patients were divided into two groups, those who underwent open reduction and internal fixation and those treated with minimally invasive plates. The two groups were statistically compared in terms of radiological and clinical scores and complication rates (p=0.05). Comparative analysis was also performed for three fracture types in both groups. ResultsTwenty patients were treated with a minimally invasive approach and 24 patients were treated with the open reduction method. Age, gender, fracture type, and follow-up times were similar between the two groups (p>0.05). There was no statistically significant difference between postop American Orthopaedic Foot and Ankle Society Ankle-Hindfoot Score (AOFAS), anterior distal tibial angle (ADTA), or lateral distal tibial angle (LDTA) values between both groups. There was also no difference in union times or nonunion rates (p>0.05). There was no statistically significant difference in rates of superficial skin problems or deep infections between the two groups (p>0.05). In comparison regarding fracture types, patients with type C fractures seemed to have better outcomes with minimal invasive plating. ConclusionMinimally invasive plating is a good approach in the treatment of distal tibial fractures. The technique seems to be advisable, especially for patients with type C fractures. However, the rates of skin problems and deep infections are similar to those seen with the open reduction method.

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Section: Discussionmentioning

confidence: 99%

“…The most important problems encountered in the treatment of distal tibial fractures with open reduction are superficial skin necrosis and deep infections [ 11 , 13 ]. However, an anatomical reduction can be achieved through open reduction, which is very important for long-term results [ 3 ].…”

Section: Discussionmentioning

confidence: 99%

Comparison of Open Reduction and Internal Fixation With Minimally Invasive Plating in the Treatment of Distal Tibial Fractures: A Retrospective Study

Akdemir¹,

Turan²,

Türken³

et al. 2022

Cureus

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“…In the literature there is a controversy when comparing the rate of infection between minimal percutaneous fixation and conventional open reduction and internal fixation of distal tbial fractures. Some studies report infection rate up to 31.5% with conventional platting [47] others report no significant difference between the two techniques [48,49] . The low rate of deep infection reported in the current study can be explained by the selection criteria of the patient where open fractures and cases of bad skin condition were excluded from the study.…”

Section: Discussionmentioning

confidence: 99%

Outcome of percutaneous locked plating of extra-articular distal tibial metaphyseal fractures

Abed¹,

Arafa²

2021

Hong Kong J Orthop Res

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Introduction: Management of fractures involving the distal tibial metaphysis is one of the most challenging and controversial issue due to poor soft tissue envelop. Multiple different fixation modalities are available with different outcome. Percutaneous plating of the distal tibia fracture is gaining more popularity due to minimal interruption of the fracture biology and favorable functional and radiological outcomes. Purpose: To evaluate the functional and radiological outcome of management of distal tibia extra articular metaphyseal fractures using locked plates with Minimally Invasive Plate Osteosynthesis (MIPO) technique. Methods: Twenty four patients with extra- articular distal tibia metaphyseal fractures were operated with locked compression plates using MIPO technique. They were followed up at regular intervals. Functional and radiological results were evaluated at the end of follow up. Results: All fractures united at average time of 12.21 weeks (range; 8-20 weeks). Postoperatively, two patients developed deep infection and two patients developed malunion. Mean AOFAS score was excellent 90.6 points (range: 52-100) at last follow up. Conclusion: MIPO technique using distal tibia locked plating is an effective procedure for fixation of distal tibia extra-articular metaphyseal fractures. It provides near anatomical fracture reduction with sufficient stability and preservation of the blood supply to the fracture fragments. It provides excellent functional results with acceptable rate of complications.

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“…Infection is a common and frequent complication associated with all types of biomedical materials, despite the infection rate varying greatly among different intended uses of various implantable devices ( Table 2 ) [ 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 ]. Orthopedic implants, such as the ankle, hip, knee, elbow, shoulder, and finger joint prosthetics, are made of metals (titanium alloys, stainless steel, cobalt-chromium alloy, etc.)…”

Section: Clinical Features Of Device-associated Infectionsmentioning

confidence: 99%

Antibacterial Designs for Implantable Medical Devices: Evolutions and Challenges

Cao

Qiao

Qin

2022

JFB

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The uses of implantable medical devices are safer and more common since sterilization methods and techniques were established a century ago; however, device-associated infections (DAIs) are still frequent and becoming a leading complication as the number of medical device implantations keeps increasing. This urges the world to develop instructive prevention and treatment strategies for DAIs, boosting the studies on the design of antibacterial surfaces. Every year, studies associated with DAIs yield thousands of publications, which here are categorized into four groups, i.e., antibacterial surfaces with long-term efficacy, cell-selective capability, tailored responsiveness, and immune-instructive actions. These innovations are promising in advancing the solution to DAIs; whereas most of these are normally quite preliminary “proof of concept” studies lacking exact clinical scopes. To help identify the flaws of our current antibacterial designs, clinical features of DAIs are highlighted. These include unpredictable onset, site-specific incidence, and possibly involving multiple and resistant pathogenic strains. The key point we delivered is antibacterial designs should meet the specific requirements of the primary functions defined by the “intended use” of an implantable medical device. This review intends to help comprehend the complex relationship between the device, pathogens, and the host, and figure out future directions for improving the quality of antibacterial designs and promoting clinical translations.

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Risk factors for infection in fixation of distal tibia fractures

Cited by 7 publications

References 19 publications

Comparison of Open Reduction and Internal Fixation With Minimally Invasive Plating in the Treatment of Distal Tibial Fractures: A Retrospective Study

Comparison of Open Reduction and Internal Fixation With Minimally Invasive Plating in the Treatment of Distal Tibial Fractures: A Retrospective Study

Outcome of percutaneous locked plating of extra-articular distal tibial metaphyseal fractures

Antibacterial Designs for Implantable Medical Devices: Evolutions and Challenges

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