ArticleArchives of orthopaedic and trauma surgery2023
Analyzing risk factors for treatment failure in fracture-related infection.
Article in Archives of orthopaedic and trauma surgery, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.
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Who cites it
10 citing papers in PubMed, 23 citations in OpenAlex.
- Clinical characteristics and risk factors of recurrence for Pseudomonas aeruginosa-associated fracture-related infection following surgical treatment : a 12-year retrospective cohort study.Bone & joint open · 2026Article
- A qualitative study to reveal devastating impacts of chronic fracture-related infection.Scientific reports · 2026Article
- Supramolecular delivery of senolytics enables targeted anti-senescence therapy and accelerated fracture healing.Journal of nanobiotechnology · 2026Article
- Identifying risk factors for systemic complications following fracture-related infection.European journal of orthopaedic surgery & traumatology : orthopedie traumatologie · 2025Article
- Surgical and microbiological characteristics that influence the probability of reoperation to promote bone healing after fracture-related infection diagnosis.European journal of orthopaedic surgery & traumatology : orthopedie traumatologie · 2025Article
- Distally based sural flaps for soft tissue defects following traumatic osteomyelitis of lower leg and foot.Scientific reports · 2024Article
- Multisite Study of the Management of Musculoskeletal Infection After Trauma: The MMUSKIT Study.Open forum infectious diseases · 2024Article
- Time to Positivity in Blood Culture Bottles Inoculated with Sonication Fluid from Fracture-Related Infections.Microorganisms · 2024Article
- Devascularized Bone Surface Culture: A Novel Strategy for Identifying Osteomyelitis-Related Pathogens.Journal of personalized medicine · 2022Article
- Fracture Related Infections and Their Risk Factors for Treatment Failure-A Major Trauma Centre Perspective.Diagnostics (Basel, Switzerland) · 2022Article
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Authors and funding
6 authors at 4 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionFracture-related infection (FRI) represents a challenging clinical scenario. Limited evidence exists regarding treatment failure after initial management of FRI. The objective of our investigation was to determine incidence and risk factors for treatment failure in FRI. MATERIALS AND
methodsWe conducted a retrospective review of patients treated for FRI between 2011 and 2015 at three level 1 trauma centers. One hundred and thirty-four patients treated for FRI were identified. Demographic and clinical variables were extracted from the medical record. Treatment failure was defined as the need for repeat debridement or surgical revision seven or more days after the presumed final procedure for infection treatment. Univariate comparisons were conducted between patients who experienced treatment failure and those who did not. Multivariable logistic regression was conducted to identify independent associations with treatment failure.
resultsOf the 134 FRI patients, 51 (38.1%) experienced treatment failure. Patients who failed were more likely to have had an open injury (31% versus 17%; p = 0.05), to have undergone implant removal (p = 0.03), and additional index I&D procedures (3.3 versus 1.6; p < 0.001). Most culture results identified a single organism (62%), while 15% were culture negative. Treatment failure was more common in culture-negative infections (p = 0.08). Methicillin-resistant Staphylococcus aureus (MRSA) was the most common organism associated with treatment failure (29%; p = 0.08). Multivariate regression demonstrated a statistically significant association between treatment failure and two or more irrigation and debridement (I&D) procedures (OR 13.22, 95% CI 4.77-36.62, p < 0.001) and culture-negative infection (OR 4.74, 95% CI 1.26-17.83, p = 0.02).
conclusionsThe rate of treatment failure following FRI continues to be high. Important risk factors associated with treatment failure include open fracture, implant removal, and multiple I&D procedures. While MRSA remains common, culture-negative infection represents a novel risk factor for failure, suggesting aggressive treatment of clinically diagnosed cases remains critical even without positive culture data. LEVEL OF EVIDENCE: Retrospective cohort study; Level III.
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