ABSTRACT
Objective·To examine the seasonality of post-traumatic wound infection (PWI) and surgery site infection (SSI) from the perspectives of occurrence and microbiological distribution.Methods·The cumulative incidences of PWI and SSI in different seasons were respectively calculated and compared in a cohort of 2 177 patients who sustained open-wounded injuries in the upper or lower extremity and a cohort of 11 809 patients receiving selective orthopedic operation from 2013 to 2015 in Shanghai Sixth People's Hospital.Multifactorial linear regression was used to measure the influence of meteorological parameters on PWI incidence.Moreover,the microbiological distribution of PWI and SSI was analyzed on a seasonal basis.Results·The incidence of PWI in the patients was 2.20％ from 2013 to 2015,and there were significant seasonal patterns (1.04％ in spring,3.52％ in summer,3.10％ in autumn,0.71％ in winter,P=0.004).The incidence of SSI was 0.21％,and there was no seasonal difference (P=0.809).Only average temperature (P=0.002,β=0.016) was correlated with the occurrence of PWI in multifactorial linear regression analysis.Microbiological analysis revealed the dominance of Gram-negative bacteria in SSI cases during the summer and autumn (P=0.021).However,this trend was not observed in PWI cases (P=0.694).Conclusion·There is a seasonal pattern in PWI occurrence with peaks in summer and auturrm,which is correlated with temperature.There is no seasonal difference in SSI incidence,but SSI cases were dominantly infected by Gram-negative bacteria in summer and autumn.
ABSTRACT
<p><b>BACKGROUND</b>Traditionally, displaced greater tuberosity fractures are treated with open reduction and internal fixation. Arthroscopic treatment and outcome of greater tuberosity fractures is far from comprehensive. The objective of the current study was to assess the surgical procedure and outcome of an arthroscopic method in the treatment of isolated greater tuberosity fractures.</p><p><b>METHODS</b>From January 2006 to December 2009, 23 patients with isolated greater tuberosity fractures were treated with an arthroscopic procedure using three cannulated screws combined with washers. During follow-up, radiographs and the constant shoulder score (CSS) were used to evaluate the outcome.</p><p><b>RESULTS</b>Three cannulated screws with washers were used to fix the fractured fragment of the greater tuberosity under an arthroscope. All incisions healed at primary intention without infection. The mean duration of follow-up was 20 months (range 18 - 36 months). Fracture fixation was excellent, and fractures healed 2 - 6 months (mean 3.8 months) after surgery. At final follow-up, the CSS was 92 (range 86 - 100).</p><p><b>CONCLUSIONS</b>The described arthroscopic procedure provides anatomical reduction and firm fixation for isolated greater tuberosity fractures. It is a successful and minimally invasive procedure with satisfying therapeutic effects as well as excellent functional recovery.</p>