Risk of Surgical Site Infections in OTA/AO Type C Tibial Plateau and Tibial Plafond Fractures: A Systematic Review and Meta-Analysis

Travis S. Bullock, Samuel S. Ornell, Jose M.G. Naranjo, Nicholas Morton-Gonzaba, Patrick Ryan, Matthew Petershack, Luis M. Salazar, Alvaro Moreira, Boris A. Zelle

Research output: Contribution to journalReview articlepeer-review

2 Scopus citations

Abstract

Objectives:To analyze the current incidence of postoperative infection for OTA/AO type C fractures of the tibial plateau and tibial plafond.Data Sources: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.Study Selection: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.Data Extraction: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.Data Synthesis: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.Conclusions: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.Level of Evidence:Prognostic Level IV. See Instructions for Authors for a complete description of levels of evidence.

Original languageEnglish (US)
Pages (from-to)111-117
Number of pages7
JournalJournal of orthopaedic trauma
Volume36
Issue number3
DOIs
StatePublished - Mar 1 2022

Keywords

  • fracture
  • high-energy
  • infection
  • plafond
  • plateau
  • tibia

ASJC Scopus subject areas

  • Surgery
  • Orthopedics and Sports Medicine

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