Bullock Travis S, Ornell Samuel S, Naranjo Jose M G, Morton-Gonzaba Nicholas, Ryan Patrick, Petershack Matthew, Salazar Luis M, Moreira Alvaro, Zelle Boris A
Departments of Orthopaedics, and.
Medicine, UT Health San Antonio, San Antonio, TX.
J Orthop Trauma. 2022 Mar 1;36(3):111-117. doi: 10.1097/BOT.0000000000002259.
To analyze the current incidence of postoperative infection for OTA/AO type C fractures of the tibial plateau and tibial plafond.
Three medical databases: PubMed/MEDLINE, ScienceDirect, and the Cochrane Library, were used in our systematic literature search. Search results were restricted to articles transcribed in English/Spanish and publication date after January 1, 2000, to present day.
Inclusion criteria were studies reporting postoperative infection data for OTA/AO type 41C, 43C, or equivalent fractures of skeletally mature individuals. A minimum of 6 total fractures of interest and a frequency of 75% overall were required. Studies reporting on pathologic fractures, stress fractures, or low-energy fracture types were excluded.
Two authors independently screened abstracts, evaluated full-text manuscripts, and extracted relevant data from included studies. Any instances of discrepancy were resolved within the study committee by consensus.
Outcomes were expressed using direct proportions (PR) with a 95% confidence interval. The effects of comorbidities on infection rates were reported using odds ratios with a 95% confidence interval. All analyses used a DerSimonian-Laird estimate with a random-effects model based on heterogeneity. The presence of publication bias was evaluated using funnel plots and Egger's tests.
Patients with these specific fractures develop infections at a notable frequency. The rates of deep infections were approximately 6% in tibial plateau fractures and 9% in tibial plafond fractures. These results may be useful as a reference for patient counseling and other future studies aimed at minimizing postoperative infection for these injuries.
Prognostic Level IV. See Instructions for Authors for a complete description of levels of evidence.
分析胫骨平台和胫骨干骺端OTA/AO C型骨折术后感染的当前发生率。
我们在系统文献检索中使用了三个医学数据库：PubMed/MEDLINE、ScienceDirect和Cochrane图书馆。检索结果仅限于2000年1月1日以后发表的英文/西班牙文文章。
纳入标准为报告骨骼成熟个体的OTA/AO 41C、43C型或等效骨折术后感染数据的研究。至少需要6例感兴趣的骨折，总体频率为75%。排除报告病理性骨折、应力性骨折或低能量骨折类型的研究。
两位作者独立筛选摘要、评估全文手稿，并从纳入研究中提取相关数据。任何差异情况均在研究委员会内部通过协商一致解决。
结果以直接比例（PR）表示，并带有95%置信区间。使用带有95%置信区间的比值比报告合并症对感染率的影响。所有分析均采用基于异质性的DerSimonian-Laird估计和随机效应模型。使用漏斗图和Egger检验评估发表偏倚的存在。
患有这些特定骨折的患者感染频率较高。胫骨平台骨折的深部感染率约为6%，胫骨干骺端骨折的深部感染率约为9%。这些结果可能有助于为患者咨询以及其他旨在尽量减少这些损伤术后感染的未来研究提供参考。
预后IV级。有关证据水平的完整描述，请参阅《作者须知》。
