Abstract：
UNASSIGNED: Open fractures of the talar body and neck are uncommon. Previous reports of associated deep infection rates and resulting surgical requirements vary widely. The primary objective of this study is to report the incidence of deep infections for isolated open talar body and neck fractures, and secondarily the incidence and number of total surgeries performed (TSP), secondary salvage procedures (SSPs), and nonsalvage procedures (NSPs).
UNASSIGNED: Retrospective case-control study of 32 consecutive isolated open talus fracture patients (22 neck, 10 body) were followed for an average of 39.2 months.
UNASSIGNED: Five (15.6%) fractures developed deep infections. Fifty percent of open body fractures became infected compared with 0% of neck fractures (P < .001). There was no difference between infected group (IG) and uninfected fracture group (UG) with respect to age, sex, body mass index, tobacco, diabetes, vascular disease, open fracture type, wound location, hours to irrigation and debridement, or definitive treatment. The majority (92.6%) of UG fractures used a dual incision with open wound extension. There were more single extensile approaches in the IG group (P = .04). The IG required 5.8 TSP per patient compared with 2.1 in the UG (P = .004). All (100%) of the IG required an SSP compared with 29.6% of the UG (P = .006). All (100%) of the IG required an NSP compared to 40.7% of the UG (P = .043). In the IG, 2.8 NSPs per patient were required after definitive surgery compared with 1.18 in the UG (P = .003). Of those followed 1 year, the incidence of SSP remained higher in the IG (P = .016).
UNASSIGNED: The incidence of deep infection following isolated open talar fractures is high and occurs disproportionally in body fractures. Infected fractures required nearly 6 surgeries, and all required SSP.
UNASSIGNED: Level IV, prognostic.
UNASSIGNED: Retrospective case-control study of 32 consecutive isolated open talus fracture patients (22 neck, 10 body) were followed for an average of 39.2 months.
UNASSIGNED: Five (15.6%) fractures developed deep infections. Fifty percent of open body fractures became infected compared with 0% of neck fractures (P < .001). There was no difference between infected group (IG) and uninfected fracture group (UG) with respect to age, sex, body mass index, tobacco, diabetes, vascular disease, open fracture type, wound location, hours to irrigation and debridement, or definitive treatment. The majority (92.6%) of UG fractures used a dual incision with open wound extension. There were more single extensile approaches in the IG group (P = .04). The IG required 5.8 TSP per patient compared with 2.1 in the UG (P = .004). All (100%) of the IG required an SSP compared with 29.6% of the UG (P = .006). All (100%) of the IG required an NSP compared to 40.7% of the UG (P = .043). In the IG, 2.8 NSPs per patient were required after definitive surgery compared with 1.18 in the UG (P = .003). Of those followed 1 year, the incidence of SSP remained higher in the IG (P = .016).
UNASSIGNED: The incidence of deep infection following isolated open talar fractures is high and occurs disproportionally in body fractures. Infected fractures required nearly 6 surgeries, and all required SSP.
UNASSIGNED: Level IV, prognostic.
摘要：
■距骨和颈部的开放性骨折并不常见。以前有关深部感染率和手术要求的报道差异很大。这项研究的主要目的是报告孤立的开放性距骨和颈部骨折的深部感染的发生率，其次是手术总数（TSP）的发生率和数量，二次打捞程序(SSP)，和非救助程序(NSP)。
■32例连续孤立的开放性距骨骨折患者的回顾性病例对照研究（22颈，10例)随访,平均39.2个月。
■5处（15.6%）骨折发生深部感染。与0％的颈部骨折相比，50％的开放性身体骨折被感染（P<0.001）。感染组（IG）和未感染骨折组（UG）在年龄上没有差异，性别,身体质量指数,烟草,糖尿病,血管疾病,开放性骨折类型,伤口位置,小时灌溉和清创，或确定的治疗。大多数（92.6％）的UG骨折使用开放伤口延伸的双切口。IG组中有更多的单一延伸方法(P=.04)。IG每位患者需要5.8TSP，而UG为2.1（P=.004）。所有（100％）的IG需要SSP，而UG的29.6％（P=.006）。与UG的40.7%(P=0.043)相比,所有(100%)IG需要NSP。在IG中,确定性手术后每位患者需要2.8NSP，而UG为1.18（P=.003）。其中1年后，IG中SSP的发生率仍然较高（P=0.016）。
■孤立的开放性距骨骨折后深部感染的发生率很高，并且在身体骨折中不成比例地发生。感染骨折需要近6次手术,和所有需要的SSP。
■四级，预后。
■32例连续孤立的开放性距骨骨折患者的回顾性病例对照研究（22颈，10例)随访,平均39.2个月。
■5处（15.6%）骨折发生深部感染。与0％的颈部骨折相比，50％的开放性身体骨折被感染（P<0.001）。感染组（IG）和未感染骨折组（UG）在年龄上没有差异，性别,身体质量指数,烟草,糖尿病,血管疾病,开放性骨折类型,伤口位置,小时灌溉和清创，或确定的治疗。大多数（92.6％）的UG骨折使用开放伤口延伸的双切口。IG组中有更多的单一延伸方法(P=.04)。IG每位患者需要5.8TSP，而UG为2.1（P=.004）。所有（100％）的IG需要SSP，而UG的29.6％（P=.006）。与UG的40.7%(P=0.043)相比,所有(100%)IG需要NSP。在IG中,确定性手术后每位患者需要2.8NSP，而UG为1.18（P=.003）。其中1年后，IG中SSP的发生率仍然较高（P=0.016）。
■孤立的开放性距骨骨折后深部感染的发生率很高，并且在身体骨折中不成比例地发生。感染骨折需要近6次手术,和所有需要的SSP。
■四级，预后。
