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The Archives of Bone and Joint Surgery، جلد ۱۰، شماره ۶، صفحات ۵۱۴-۵۲۴
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عنوان انگلیسی Implant Removal Due to Infection After Open Reduction and Internal Fixation: Trends and Predictors
چکیده انگلیسی مقاله Background: Implant removal due to infection is one of the major causes failure following open reduction and internal fixation (ORIF). The aim of this study was to determine trends and predictors of infection-related implant removal following ORIF of extremities using a nationally representative database.Methods: Nationwide Inpatient Sample data from 2006 to 2017 was used to identify cases of ORIF following upper and lower extremity fractures, as well as cases that underwent infection-related implant removal following ORIF. Multivariate analysis was performed to identify independent predictors of infection-related implant removal, controlling for patient demographics and comorbidities, hospital characteristics, site of fracture, and year. Results: For all ORIF procedures, the highest rate of implant removal due to infection was the phalanges/hand (5.61%), phalanges/foot (5.08%), and the radius/ulna (4.85%). Implant removal rates due to infection decreased in all fractures except radial/ulnar fractures. Tarsal/metatarsal fractures (odds ratio (OR)=1.45, 95% confidence interval (CI): 1.02-2.05), and tibial fractures (OR=1.82, 95% CI: 1.45-2.28) were identified as independent predictors of infection-related implant removal. Male gender (OR=1.67, 95% CI: 1.49-1.87), Obesity (OR=1.85, 95% CI: 1.34-2.54), diabetes mellitus with chronic complications (OR=1.69, 95% CI: 1.13-2.54, P< 0.05), deficiency anemia (OR=1.59, 95% CI: 1.14-2.22) were patient factors that were associated with increased infection-related removals. Removal of implant due to infection had a higher total charge associated with the episode of care (mean: $166,041) than non-infection related implant removal (mean: $133,110).Conclusion: Implant removal rates due to infection decreased in all fractures except radial/ulnar fractures. Diabetes, liver disease, and rheumatoid arthritis were important predictors of infection-related implant removal. The study identified some risk factors for implant related infection following ORIF, such as diabetes, obesity, and anemia, that should be studied further to implement strategies to reduce rate of infection following ORIF.Level of evidence: III
کلیدواژه‌های انگلیسی مقاله Fracture, implant removal, infection-related implant removal, Infection, Septic Hardware
نویسندگان مقاله | Alec Kellish
Cooper Medical School of Rowan University, Camden, New Jersey, USA


| Alisina Shahi
Department of Orthopaedic Surgery, Cooper University Hospital, Camden, New Jersey, USA


| Julio Rodriguez Jr.
Cooper Medical School of Rowan University, Camden, New Jersey, USA


| Kudret Usmani
Department of Orthopaedic Surgery, Cooper University Hospital, Camden, New Jersey, USA


| Michael Boniello
Department of Orthopaedic Surgery, Cooper University Hospital, Camden, New Jersey, USA


| Ali Oliashirazi
Oliashirazi Institute at Marshall University, Huntington, West Virginia, USA


| Graf Keneth
Department of Orthopaedic Surgery, Cooper University Hospital, Camden, New Jersey, USA


| Henry Dolch
Department of Orthopaedic Surgery, Cooper University Hospital, Camden, New Jersey, USA


| David Fuller
Department of Orthopaedic Surgery, Cooper University Hospital, Camden, New Jersey, USA


| Rakesh Mashru
Department of Orthopaedic Surgery, Cooper University Hospital, Camden, New Jersey, USA
نشانی اینترنتی https://abjs.mums.ac.ir/article_18977.html
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زبان مقاله منتشر شده en
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نوع مقاله منتشر شده RESEARCH PAPER
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