Is It Safe to Prep the External Fixator In Situ During Second-Stage Pilon Surgical Treatment?

OBJECTIVE

To evaluate the infection rate of our protocol of prepping the external fixator in situ during definitive second-stage pilon fracture open reduction internal fixation.

DESIGN

Retrospective clinical investigation.

SETTING

Academic Level 1 Trauma Center.

PATIENTS/PARTICIPANTS: Out of 229 patients with distal tibia fractures presenting to our institution from 1999 to 2014, 100 were treated in a 2-stage fashion utilizing this protocol.

INTERVENTION

Prepping the external fixator into the surgical field during the second-stage/definitive open reduction internal fixation procedure.

MAIN OUTCOME MEASUREMENT

The rates of deep and superficial infections after definitive fixation.

RESULTS

The deep infection rate was 13%, and the superficial infection rate was 11%.

CONCLUSIONS

Infection rates using this protocol are comparable to previously reported infection rates for two-stage surgical treatment of pilon fractures. This protocol provides the treating surgeon information about an alternative method to streamline definitive fixation.

LEVEL OF EVIDENCE

Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.