Analysis of risk factors of infection for complex tibial plateau fractures after operation / 中国骨伤

ABSTRACT

<p><b>OBJECTIVE</b>To analyze the risk factor of infection for complex tibial plateau fractures after operation.</p><p><b>METHODS</b>Totally clinical data of 293 patients with complex tibial plateau fractures underwent open reduction and internal fixation were retrospectively analyzed from September 2010 to March 2015, including 199 males and 94 females, ranging in age from 17 to 80 years old with an average of 47.3 years old. The possible risk factors such as gender, age, smoking, diabetes, type of fracture(open/closed), classification of open fracture(Gustilo-Anderson classification), classification of soft tissue injury in closed fracture (Tscherne-Gotzen classification), fracture classification(Schatzker V/VI), osteofascial compartment syndrome, ASA score, anesthesia, timing of surgery, operative time(<=150 min/>150 min), surgical approach, combined approach or not, internal fixation site were studied. The multivariate Logistic regression model was used to analyze the risk factors.</p><p><b>RESULTS</b>Twelve patients were infected of all 293 patients after operation, the infection rate was 4.10%. Univariate analysis showed that fracture type(χ ² =14.496,=0.001), fracture classification(χ²=4.560,=0.033), osteofascial compartment syndrome(χ²=15.631,=0.001), operative time(χ²=11.233,=0.001) were correlated with complex tibial plateau fractures postoperative infection. Multivariate analysis showed that open fractures(χ²=9.696,=0.002) and osteofascial compartment syndrome(χ²=9.119,=0.003) were complex tibial plateau fracture risk factors for infection after operation.</p><p><b>CONCLUSIONS</b>Open fractures and osteofascial compartment syndrome are risk factor of complex tibial plateau fracture for infection after operation. While through debridement for open fracture patients, early diagnosis and promt treatment for osteofascial compartment syndrome could reduce incidence of infection.</p>