Wound complications after open reduction and internal fixation of tibial plateau fractures in the elderly: a multicentre study
Wound complications after open reduction and internal fixation of tibial plateau fractures in the elderly: a multicentre study
复制标题
DOI：
10.1007/s00264-018-3940-9
复制
发表时间：
2019-02-01
影响因子：
2.7
通讯作者：
Zelle, Boris A.
中科院分区：
文献类型：
--
作者：
Gaunder, Christopher L.;Zhao, Zibin;Zelle, Boris A.
据报道，年轻患者胫骨平台骨折切开复位内固定（ORIF）后伤口并发症的发生率约为5 - 15%。关于老年患者伤口并发症发生率的报告有限。本研究调查的发生率术后伤口并发症的老年患者接受ORIF的胫骨平台fractures.MethodsA回顾性研究进行了三个认可的1级创伤中心。入选患者年龄> 60岁，胫骨平台骨折行切开复位内固定。主要结局指标为手术部位的伤口并发症。这些被分为浅表感染与深部infections.Results102例患者符合纳入标准。其中，16例患者（15.7%）发生术后伤口感染。基础合并症和风险因素分析显示，与阿萨1级和2级相比，美国麻醉医师协会（阿萨）3级和4级患者的伤口并发症持续风险显著增加（23.7对5.1%，p=0.015）结论接受ORIF治疗胫骨平台骨折的老年患者的总体感染率与发表的年轻患者的数据相似人口。特别是，没有明显合并症的老年患者似乎是胫骨平台骨折ORIF的合适候选者。然而，具有显著共病的老年患者必须被视为高风险，应在这些患者中探索替代治疗方案，如非手术治疗或微创手术方案。
PurposeThe incidence of wound complications after open reduction with internal fixation (ORIF) of tibial plateau fractures in young patients has been reported to range from approximately 5 to 15%. Reports on wound complication rates in the elderly patients are limited. This study investigates the incidence of post-operative wound complications in elderly patients undergoing ORIF of their tibial plateau fractures.MethodsA retrospective study was performed within three accredited level 1 trauma centres. Patients >60years of age undergoing open reduction and internal fixation of their tibial plateau fractures were included. The primary outcome measure was wound complications of the surgical site. These were divided into superficial infections versus deep infections.ResultsOne hundred two patients matched the inclusion criteria. Of these, 16 patients (15.7%) developed a post-operative wound infection. The analysis of underlying co-morbidities and risk factors revealed that patients with American Society of Anaesthesiologists (ASA) classes 3 and 4 were at significantly increased risk of sustaining a wound complications as compared to ASA classes 1 and 2 (23.7 versus 5.1%, p=0.015).ConclusionsThe overall infection rates in elderly patients undergoing ORIF for tibial plateau fractures is in a similar range to published data on younger patient populations. In particular, elderly patients without significant co-morbidities seem to be appropriate candidates for ORIF of their tibial plateau fractures. However, elderly patients with significant co-morbidities must be considered as high risk and alternative treatment options, such as nonoperative treatment or less invasive surgical options, should be explored in these patients.