Surgical site infection in tibial plateau fractures with ipsilateral compartment syndrome |
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Affiliation: | 1. Joint Base Elmandorf, JBER, AK, 99506 USA;2. San Antonio Military Medical Center, Fort Sam Houston, TX, 78234, USA;3. The Hand Center, San Antonio, TX, 78240, USA;1. Department of Physiology, Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran;2. Department of Clinical Biochemistry, School of Medicine, Tarbiat Modares University, Tehran, Iran;3. Protein Chemistry Lab, Biotechnology Research Center, Pasteur Institute of Iran, Tehran, Iran |
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Abstract: | AimThe aim of this study was to investigate the effects of compartment syndrome and timing of fasciotomy wound closure on surgical site infection (SSI) after surgical fixation of tibial plateau fractures. Our primary hypothesis was that SSI rate is increased for fractures with compartment syndrome versus those without, even accounting for confounders associated with infection. Our secondary hypothesis was that infection rates are unrelated to timing of fasciotomy closure or fixation.Materials and methodsWe conducted a retrospective cohort study of operative tibial plateau fractures with ipsilateral compartment syndrome (n = 71) treated with fasciotomy at our level I trauma center from 2003 through 2011. A control group consisted of 602 patients with 625 operatively treated tibial plateau fractures without diagnosis of compartment syndrome. The primary outcome measure was deep SSI after ORIF.ResultsFractures with compartment syndrome had a higher rate of SSI (25% versus 8%, p < 0.001). The difference remained significant in our multivariate model (odds ratio, 7.27; 95% confidence interval, 3.8–13.9). Delay in timing of fasciotomy closure was associated with a 7% increase per day in odds of infection (95% confidence interval, 0.2–13; p < 0.05).ConclusionsTibial plateau fractures with ipsilateral compartment syndrome have a significant increase in rates of SSI compared with those without compartment syndrome (p < 0.001). Delays in fasciotomy wound closure were also associated with increased odds of SSI (p < 0.05). |
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Keywords: | Compartment syndrome Tibial plateau fracture Surgical site infection Complication |
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