Wound complications after open reduction and internal fixation of tibial plateau fractures in the elderly: a multicentre study

Gaunder, Christopher; Zhao, Zhenyu; Henderson, Corey; McKinney, Brandon; Stahel, Philip F.; Zelle, Boris A.

doi:10.1007/s00264-018-3940-9

Cited by 27 publications

(16 citation statements)

References 19 publications

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“…Of these, 71 studies 2,10,53,54,55,56,57,58,59,60,61,62,63,64,65,66,67,68,69,70,71,72,73,74,75,76,77,78,79,80,81,82,83,84,85,86,87,88,89,90,91,92,93,94,95,96,97,98,99,100,101,102,103,104,105,106,107,108,109,110,111,112,113,114,115,116,117,118,119,120,121 (60.7%) evaluated tibial plateau fractures, 16 studies 14,15,16,17,18,19,20,21,22,23,…”

Section: Resultsmentioning

confidence: 99%

Prevalence of Deep Surgical Site Infection After Repair of Periarticular Knee Fractures

et al. 2019

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Section: Resultsmentioning

confidence: 99%

Prevalence of Deep Surgical Site Infection After Repair of Periarticular Knee Fractures

et al. 2019

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“…weight, smoking, previous illnesses) and fracture-or operation-dependent factors (e.g. fracture morphology, compartment syndrome, polytrauma) [16][17][18]. Furthermore, the exact mechanism on how fracturoscopy has a positive effect on reducing SSI remains unclear; possible factors may include low operative complication rates such as lower blood loss and smaller operative approach with less soft tissue damage.…”

Section: Discussionmentioning

confidence: 99%

Effect of fracturoscopy on the incidence of surgical site infections post tibial plateau fracture surgery

Henkelmann¹,

Krause

Alm³

et al. 2020

Eur J Trauma Emerg Surg

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Purpose Surgical treatment of tibial plateau fracture (TPF) is common. Surgical site infections (SSI) are among the most serious complications of TPF. This multicentre study aimed to evaluate the effect of fracturoscopy on the incidence of surgical site infections in patients with TPF. Methods We performed a retrospective multicentre study. All patients with an AO/OTA 41 B and C TPF from January 2005 to December 2014 were included. Patients were divided into three groups: those who underwent arthroscopic reduction and internal fixation (ARIF), and those who underwent open reduction and internal fixation (ORIF) with fracturoscopy, and those treated with ORIF without fracturoscopy. The groups were compared to assess the effect of fracturoscopy. We characterised our cohort and the subgroups using descriptive statistics. Furthermore, we fitted a logistic regression model which was reduced and simplified by a selection procedure (both directions) using the Akaike information criterion (AIC). From the final model, odds ratios and inclusive 95% confidence intervals were calculated. Results Overall, 52 patients who underwent fracturoscopy, 48 patients who underwent ARIF, and 2000 patients treated with ORIF were identified. The rate of SSI was 0% (0/48) in the ARIF group and 1.9% (1/52) in the fracturoscopy group compared to 4.7% (93/2000) in the ORIF group (OR = 0.40, p = 0.37). Regression analyses indicated a potential positive effect of fracturoscopy (OR, 0.65; 95% CI, 0.07–5.68; p = 0.69). Conclusion Our study shows that fracturoscopy is associated with reduced rates of SSI. Further studies with larger cohorts are needed to investigate this. Level of evidence Level III.

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“…Lastly, frail elderly patients often have a significant number of comorbidities combined with reduced mobility, which results in a more wait and see attitude. However, as age is not an independent risk facture and elderly patients are not prone to infection [6,10,11]. As the used database is an insurance and cost oriented database, composed and controlled by the government it unfortunately does not allow us to diversify into supplementary data that is of interest to the trauma surgeon (e.g.…”

Section: Discussionmentioning

confidence: 99%

Tibial plateau fractures in Belgium: epidemiology, financial burden and costs curbing strategies

Herteleer

Brandt

Vandoren³

et al. 2020

Eur J Trauma Emerg Surg

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We describe the incidence of tibial plateau fractures and the evolution of its management and financial burden in Belgium, perform a similar audit at University Hospitals Leuven, and define strategies to curb the increasing cost. Methods National data on tibial plateau fractures was collected from the NIHDI and compared to our performance. Several clinical parameters such as age, sex, treatment modality and length-of-stay were included. The total healthcare costs are considered as the sum of hospitalization costs and ambulatory care costs. ResultsBetween 2006 and 2018, a total number of 35,226 tibial plateau fractures were diagnosed in Belgium and 861 in our center. The incidence increased 41% over time (mean 25/100,000 persons per year). The mean rate of surgery in Belgium was 37% and slightly decreased over time, due to a larger increase of nonoperatively treated tibial plateau fractures. The rate of surgery at the UHL was 49%. Surprisingly, the average cost per patient was equal for operatively and non-operatively treated patients in Belgium, and driven by the length-of stay. ConclusionSince length-of-stay is the main driver of the total healthcare costs of tibial plateau fractures, guidelines on appropriate length-of-stay can help to decrease variability and curb the total healthcare costs, particularly of the non-operatively treated patients. Our performance was in line with this.

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Wound complications after open reduction and internal fixation of tibial plateau fractures in the elderly: a multicentre study

Cited by 27 publications

References 19 publications

Prevalence of Deep Surgical Site Infection After Repair of Periarticular Knee Fractures

Prevalence of Deep Surgical Site Infection After Repair of Periarticular Knee Fractures

Effect of fracturoscopy on the incidence of surgical site infections post tibial plateau fracture surgery

Tibial plateau fractures in Belgium: epidemiology, financial burden and costs curbing strategies

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