Abstract
Summary. The number of complications in the treatment of bone fractures, including infectious ones, remains significant. Therefore, there is a need to carry out all measures aimed at improving the treatment results for this category of patients.
Objective. The objective of our study was to determine the frequency and structure of infectious complications in patients after osteosynthesis of the long bones of the lower limbs depending on the location and type of osteosynthesis.
Material and Methods. For our study, 140 cases of infectious complications after osteosynthesis of long bones of the lower limbs were analyzed.
Results. An integral analysis of the distribution of the retrospective array of studies based on localization in the femur revealed that the infectious process is most often localized in patients with 32B hip fractures. This type of damage was observed in 29.0% of patients of the general array, where it took the first place. Infectious complications after plate osteosynthesis also prevailed, but were detected less often, in 21.2% of cases. Among the patients after blocking intramedullary osteosynthesis, 32B was detected in more than half of the cases, which is 2.5 times more often than among the patients with plate fixation. Similar results were found in patients with damage to the shin.
Conclusions. The results of the analysis indicate that in cases of infectious complications after osteosynthesis of the bones of the lower extremities, damage to the diaphyseal part of the hip was detected most often. This indicates that the development of infectious complications was significantly influenced by the patient’s condition and the intervention performed.
References
Baecker H, Frieler S, Schildhauer TA, Gessmann J, Hanusrichter Y. Fracture-related infections in traumatology : Current standards and new developments in diagnostics and treatment]. Orthopade. 2020 Aug;49(8):702-709. doi: 10.1007/s00132-020-03948-y.
Bezstarosti H, Van Lieshout EMM, Voskamp LW, Kortram K, Obremskey W, McNally MA, et al. Insights into treatment and outcome of fracture-related infection: a systematic literature review. Arch Orthop Trauma Surg. (2019) 139(1):61–72. https://doi.org/10.1007/s00402-018-3048-0
British Orthopaedic Association . Fracture Related Infections. British Orthopaedic Association Standards for Trauma & Orthopaedics; [(last access: 8 April 2021)]. 2019. available at: https://www.boa.ac.uk/uploads/assets/dee7cba7-5919-4f26
Doshi P, Gopalan H, Sprague S, et al. Incidence of infection following internal fixation of open and closed tibia fractures in India (INFINITI): amulti-centre observational cohort study. BMC Musculoskelet Disord.2017;18:156–210
Jiang N, Wang BW, Chai YM, Wu XB, Tang PF, Zhang YZ, Yu B. Chinese expert consensus on diagnosis and treatment of infection after fracture fixation. Injury. 2019. Nov;50(11):1952-1958. doi: 10.1016/j.injury.2019.08.002.
Finelli CA, Dos Reis FB, Fernandes HA, et al. Intramedullary reaming modality for management of postoperative long bone infection: a prospective randomized controlled trial in 44 patients. Patient Saf Surg. 2019; 13: 39. doi: 10.1186/s13037-019-0215-3
He SY, Yu B, Jiang N. Current Concepts of Fracture-Related Infection. Int J Clin Pract. 2023 Apr 25;2023:4839701. doi: 10.1155/2023/4839701
Liu K, Zhang H, Maimaiti X, Yusufu A. Bifocal versus trifocal bone transport for the management of tibial bone defects caused by fracture-related infection: a meta-analysis. J Orthop Surg Res.2023. 25;18(1):140. doi: 10.1186/s13018-023-03636-5.
Metsemakers WJ, Morgenstern M, Senneville E, Borens O, Govaert GAM, Onsea J, et al. General treatment principles for fracture-related infection: recommendations from an international expert group. Arch Orthop Trauma Surg. 2020 Aug;140(8):1013-1027. doi: 10.1007/s00402-019-03287-4. Epub 2019 Oct 29. PMID: 31659475; PMCID: PMC7351827.
Müller SLC, Morgenstern M, Kuehl R, Muri T, Kalbermatten DF, Clauss M, Schaefer DJ, Sendi P, Osinga R. Soft-tissue reconstruction in lower-leg fracture-related infections: An orthoplastic outcome and risk factor analysis. Injury. 2021 Nov;52(11):3489-3497. doi: 10.1016/j.injury.2021.07.022. Epub 2021 Jul 16. PMID: 34304885.
Obremskey WT, Metsemakers WJ, Schlatterer DR, et al. Musculoskeletal infection in orthopaedic trauma: assessment of the 2018 international consensus meeting on musculoskeletal infection. J Bone Joint Surg Am. 2020;102:e44. DOI: 10.2106/JBJS.19.01070
Onsea J, Van Lieshout EMM, Zalavras C, Sliepen J, Depypere M. Validation of the diagnostic criteria of the consensus definition of fracture-related infection. Injury. 2022. Jun;53(6):1867-1879. doi: 10.1016/j.injury.2022.03.024.
This work is licensed under a Creative Commons Attribution 4.0 International License.