An audit on factors influencing infection in operated ankle fractures

  • H. Sharma
  • P. Vashishtha
  • V. Paode
  • R. Sharma
  • R. Kakar
Original Article
First Online:
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Accepted:

Abstract

A prospective 1-year audit was carried out on consecutive patients admitted to a district general hospital of the UK with ankle fractures needing open reduction internal fixation in order to analyse the factors affecting infection. Ninety seven percent patients had had their operative procedure within 24 h from the time of injury. Eighty four percent patients were discharged in less than 7 days period from the day of admission. All but one patient received antibiotic prophylaxis in accordance with local microbiology policy guidelines. Four out of 32 patients received therapeutic antibiotics for wound cellulitis/superficial infection. No patient had a deep infection, osteomyelitis or septic arthritis. Complex ankle trauma, post-radiography preliminary reduction of ankle fracture-dislocation in the emergency department, prolonged operating time, delayed surgery, persistent ankle swelling and unsupervised operation were common denominators in four cases with infection in ankle fracture fixation.

Keywords

Ankle Operation Infection Antibiotics Prophylaxis 

Facteurs favorisant l’infection des fractures de cheville opérées

Résumé

Une étude prospective étalée sur un an a été conduite sur une série consécutive de patients admis dans un hôpital général de district du Royaume Uni pour fractures de cheville traitées par réduction sanglante, dans le but d’analyser les facteurs influençant l’infection. 97 % des patients avaient bénéficié du traitement chirurgical dans les 24 heures suivant leur traumatisme. 84 % des patients avaient pu quitter l’hôpital moins de sept jours après leur admission. Tous les patients sauf un avaient reçu un traitement antibiotique prophylactique selon le protocole de microbiologie local. Quatre patients sur 32 qui présentaient une infection superficielle reçurent un traitement antibiotique thérapeutique. Aucun patient ne présenta d’infection profonde, d’ostéomyélite ou d’arthrite septique. Le caractère complexe du traumatisme de la cheville, la notion d’une réduction initiale d’une fracture- luxation après bilan radiologique au département des urgences, la prolongation de la durée opératoire, le délai prolongé avant l’intervention chirurgicale, l’œdème de cheville persistant, une intervention chirurgicale sans contrôle par un senior, constituent les dénominateurs communs retrouvés dans les quatre cas d’infection sur ostéosynthèse de cheville.

Mots clés

Cheville Opération Infection Antibiotiques Prophylaxie 
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Copyright information

© Springer-Verlag 2006

Authors and Affiliations

  • H. Sharma
    • 1
    • 5
  • P. Vashishtha
    • 2
  • V. Paode
    • 3
  • R. Sharma
    • 2
  • R. Kakar
    • 4
  1. 1.Royal Hospital for Sick ChildrenGlasgowUK
  2. 2.Wishaw General HospitalWishawUK
  3. 3.Monklands HospitalAirdrieUK
  4. 4.Royal Alexandra HospitalPaisleyUK
  5. 5.GlasgowUK

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