Horton et al identified risk factors for treatment failure for patients with fracture related infections. These can help to identify a patient who may require more aggressive management and patient education. The authors are from the University of Maryland, USU-Walter Reed National Military Medical Center and Johns Hopkins University.
Patient selection: infection after fracture fixation
Goal of therapy: eradicate infection and achieve osseous union
Outcome: failure to eradicate the infection after the first series of surgeries and antibiotics
Risk factors for treatment failure from multivariate analysis:
(1) polymicrobial infection
(2) reoperation involved removal of orthopedic implant
(3) Gustilo-Anderson IIIB or IIIC fracture
where:
• Gustilo-Anderson IIIB = open fracture of long bone with extensive soft tissue injury, periosteal stripping and bone exposure
• Gustilo-Anderson IIIC = open fracture of long bone with arterial lesion requiring repair
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