Purpose
The purpose of this study was to report the incidence of infection after conversion
from external fixation (EF) to internal fixation (IF) of distal radius fractures and
to evaluate the relationship between infection and secondary variables, including
time to conversion from EF to IF, internal hardware overlapping EF pin sites, and
definitive fixation with a dorsal-spanning bridge plate.
Methods
A retrospective review was performed at 2 level 1 trauma centers including all patients
aged ≥18 years from 2006 to 2019 with a distal radius fracture treated initially with
EF followed by subsequent IF. The patients were excluded from analysis if they had
<10 weeks of clinical follow-up, a history of prior distal radius surgery, or evidence
of infection before EF to IF conversion. Patient demographic data, mechanism of injury,
presence of hardware overlapping pin sites, and timing to definitive fixation were
obtained from the medical records. Infection was defined as positive intraoperative
cultures or documented return to the operating room for debridement after IF.
Results
A total of 64 fractures in 61 patients with a median age of 50 years (range, 18–75
years) were included. Infections developed in 6 patients (6 of 64 fractures). The
incidence of infection was higher in patients with a time to conversion from EF to
IF of >14 days (infection in 2 of 5 patients vs 4 of 59 patients). The incidence of
infection was similar in patients with and without hardware overlapping EF pin sites
(3 of 27 vs 3 of 37, respectively).
Conclusions
Infections occurred in 6 of 64 distal radius fractures following conversion from EF
to IF, and delay in conversion of >14 days was associated with an increased infection
risk.
Type of study/level of evidence
Therapeutic IV.
Key words
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References
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Article info
Publication history
Published online: August 02, 2022
Accepted:
June 7,
2022
Received:
November 29,
2021
Publication stage
In Press Corrected ProofFootnotes
No benefits in any form have been received or will be received related directly or indirectly to the subject of this article.
Identification
Copyright
© 2022 by the American Society for Surgery of the Hand. All rights reserved.
