Abstract：
BACKGROUND: Tibial plateau fractures are injuries prone to postoperative infection, with its reported incidence being higher than that of other fractures, between 5% and 12%. The primary objectives of this study were to quantify the postoperative infection rate of internal fixation of tibial plateau fractures (TPFs) and to identify the risk factors for this.
METHODS: Retrospective cohort study including patients who underwent TPF osteosynthesis between 2015 and 2020, in the same center. The study population was divided into two groups, according to the presence or absence of postoperative infection. Demographic variables related to the fracture, surgical parameters, as well as the need for reoperation were collected. Finally, in the case of debridement, the number of positive cultures and the pathogen responsible for the infection were collected, as well as the treatment applied.
RESULTS: One hundred and twenty-four patients were included, with a total of 14 infections (global infection rate of 11.3%). Risk factors for developing infection were open fractures (p=.002), Schatzker V and VI type fractures (p=.002) and the use of external fixation (p<.001). Regarding the surgical variables, only the longest ischemia time (p=.032) was identified as a risk factor. Staphylococcus aureus was the most frequently identified microorganism (43%), followed by Enterobacter cloacae (35.7%).
CONCLUSIONS: The overall infection rate after osteosynthesis of tibial plateau fractures was 11.3%. Different factors are associated with a higher risk of infection, including diabetes mellitus, open fractures, the use of external fixation, a higher grade in the Schatzker classification or a longer intraoperative ischemia time.
METHODS: Retrospective cohort study including patients who underwent TPF osteosynthesis between 2015 and 2020, in the same center. The study population was divided into two groups, according to the presence or absence of postoperative infection. Demographic variables related to the fracture, surgical parameters, as well as the need for reoperation were collected. Finally, in the case of debridement, the number of positive cultures and the pathogen responsible for the infection were collected, as well as the treatment applied.
RESULTS: One hundred and twenty-four patients were included, with a total of 14 infections (global infection rate of 11.3%). Risk factors for developing infection were open fractures (p=.002), Schatzker V and VI type fractures (p=.002) and the use of external fixation (p<.001). Regarding the surgical variables, only the longest ischemia time (p=.032) was identified as a risk factor. Staphylococcus aureus was the most frequently identified microorganism (43%), followed by Enterobacter cloacae (35.7%).
CONCLUSIONS: The overall infection rate after osteosynthesis of tibial plateau fractures was 11.3%. Different factors are associated with a higher risk of infection, including diabetes mellitus, open fractures, the use of external fixation, a higher grade in the Schatzker classification or a longer intraoperative ischemia time.
摘要：
背景：胫骨平台骨折是容易发生术后感染的损伤，报告的发病率高于其他骨折，5%到12%之间。本研究的主要目的是量化胫骨平台骨折（TPF）内固定术后感染率，并确定其危险因素。
方法：回顾性队列研究，包括2015年至2020年在同一中心接受TPF骨合成术的患者。研究人群分为两组，根据术后有无感染。与骨折相关的人口统计学变量，手术参数,以及重新手术的需要被收集。最后,在清创的情况下，收集阳性培养物的数量和引起感染的病原体，以及应用的治疗。
结果：纳入了120名患者，共有14例感染(全球感染率为11.3%)。发生感染的危险因素是开放性骨折（P=0.002），SchatzkerV型和VI型骨折（P=0.002）和使用外固定（P<.001）。关于手术变量，只有最长的缺血时间(P=.032)被确定为危险因素。金黄色葡萄球菌是最常见的微生物(43%)，其次是阴沟肠球菌(35.7%)。
结论：胫骨平台骨折接骨术后总感染率为11.3%。不同的因素与较高的感染风险相关，包括糖尿病,开放性骨折,使用外固定，Schatzker分级较高，或术中缺血时间较长。
方法：回顾性队列研究，包括2015年至2020年在同一中心接受TPF骨合成术的患者。研究人群分为两组，根据术后有无感染。与骨折相关的人口统计学变量，手术参数,以及重新手术的需要被收集。最后,在清创的情况下，收集阳性培养物的数量和引起感染的病原体，以及应用的治疗。
结果：纳入了120名患者，共有14例感染(全球感染率为11.3%)。发生感染的危险因素是开放性骨折（P=0.002），SchatzkerV型和VI型骨折（P=0.002）和使用外固定（P<.001）。关于手术变量，只有最长的缺血时间(P=.032)被确定为危险因素。金黄色葡萄球菌是最常见的微生物(43%)，其次是阴沟肠球菌(35.7%)。
结论：胫骨平台骨折接骨术后总感染率为11.3%。不同的因素与较高的感染风险相关，包括糖尿病,开放性骨折,使用外固定，Schatzker分级较高，或术中缺血时间较长。
