Journal of orthopaedic trauma | 2021
What are the Risk Factors for Infection after Operative Treatment of Peritalar Fracture Dislocations?
Abstract
OBJECTIVE\nTo assess the risk factors associated with deep infection after operative treatment of peritalar fracture dislocations.\n\n\nDESIGN\nA retrospective study was performed to identify patients who had operative treatment of a peritalar fracture dislocation over an 11-year period (2008-2019).\n\n\nSETTING\nLevel 1 trauma center.\n\n\nPARTICIPANTS\nPatients were identified by review of all surgical billing that included open reduction of peritalar dislocation. Minimum follow-up for inclusion was 3 months or the outcome of interest. A total of 178 patients were identified and 154 patients met inclusion criteria.\n\n\nMAIN OUTCOME\nThe primary outcome was deep infection, defined as return to the operating room for debridement with positive cultures.\n\n\nRESULTS\nA total of 19 (12.3%) patients developed a post-operative deep infection. The most common associated fractures were talus (47%), calcaneus (33%), and fibula (9%). The infected group was significantly older (47.2 vs 39.5 years, p=0.03). Patients undergoing operative management for peritalar fracture dislocations with current smoking were found to have significantly higher odds of postoperative deep infection (74 vs 34%, aOR=7.4, 95% CI, 2.3-24.1, p=0.001). There was a significantly higher risk of infection in patients with a Gustilo-Anderson type 3 open fractures (32 vs 12%, aOR=5.7, 95% CI, 1.6-20.3, p=0.007). The infected group had high rates of below knee amputation when compared to the group without infection (47 vs 1%, p< 0.001).\n\n\nCONCLUSION\nIn our retrospective study, risk factors for infection after peritalar fracture dislocation included older age, smoking, and Gustilo-Anderson type 3 open fracture.\n\n\nLEVEL OF EVIDENCE\nPrognostic Level III. See Instructions for Authors for a complete description of levels of evidence.