Wound infection in elbow fractures: Incidence and new management protocol

Yu, Guiyong; Ren, Hua; Xiao, Aiwei; Liu, Juan; Li, Mei; Zhang, Ning

doi:10.1111/iwj.13734

Cited by 2 publications

(1 citation statement)

References 44 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Existing literature supports an overall orthopaedic surgical site infection rate of about 2.5%. 12 Infections after periarticular injuries are higher with reported rates of 5%–6% after hip fixation, 13 4%–10% after knee fixation, 14 and 4% after elbow 15 and ankle 16 fixation. Compared with the numbers cited in the literature, patients in this study who received I&D with fixation had knee infection rates that were within the range of these established values (8.3%).…”

Section: Discussionmentioning

confidence: 99%

Civilian Ballistic Arthrotomies: Infection Rates and Operative vs. Non-operative Management

Liu,

Kumar,

Liu

et al. 2023

Journal of Orthopaedic Trauma

View full text Add to dashboard Cite

OBJECTIVES: The purpose of this study was to determine if a significant difference existed in the rate of infection following ballistic traumatic arthrotomy managed operatively compared to those managed without surgery. METHODS: Design: Retrospective cohort study. Setting: Academic Level I Trauma Center. Patient Selection Criteria: Patients with ballistic traumatic arthrotomies of the shoulder, elbow, wrist, hip, knee, or ankle that received operative or non-operative management. Outcome Measures and Comparisons: The rates of infection and septic arthritis in those who received operative or non-operative management. RESULTS: One hundred ninety-five patients were studied. Eighty patients were treated non-operatively (Non-Op group), sixteen patients were treated with formal irrigation and debridement in the operating room (I&D group), and ninety-nine patients were treated with formal irrigation and debridement and open reduction and internal fixation (I&D + ORIF group). Patients in all three groups received local wound care and systemic antibiotics. No patients in the Non-Op or I&D groups developed an infection. Six patients in the I&D + ORIF group developed extra-articular post-operative infections requiring additional interventions. CONCLUSIONS: The infection rate in the I&D + ORIF group was consistent with the infection rates reported in orthopedic literature following fixation alone. Additionally, none of the infections were cases of septic arthritis. This suggests that traumatic arthrotomy does not increase the risk for infection beyond what is expected following fixation alone. Importantly, the Non-Op group represented a series of 80 patients that were treated non-operatively without developing an infection, indicating that I&D may not be necessary to prevent infection after ballistic arthrotomy. The results suggest that septic arthritis after civilian ballistic arthrotomy is a rare complication regardless of the choice of treatment. Level of evidence: Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.

show abstract