Treatment Order and Risk of Surgical Site Infection in Patients Undergoing Concurrent Operative Fixation of Closed and Open Fractures


This study aimed to characterize postoperative infection rate among patients undergoing defi nitive fi xation of both open and closed fractures during the same surgery. Outcomes between patients with open fractures (OF) treated fi rst were compared to those with closed fractures (CF) treated fi rst. We identifi ed 303 adult patients with multiple (≥ 2) pelvis and extremity fractures who presented to our Level 1 Trauma hospital in 2017. Forty patients with at least one open and one closed fracture treated with operative fi xation during the same surgery were included in analysis. Eight surgical site infections (SSI) developed in seven patients. There was no signifi cant diff erence between treatment order groups (OF = 4 patients (5 fractures), CF = 3 patients (3 fractures); p > 0.99). This is the fi rst study comparing diff erent chronologies of operative fi xation in coexisting open and closed fractures. Our study shows that the choice of treatment order does not infl uence SSI risk. (Journal of Surgical Orthopaedic Advances 31(3):181–186, 2022)

Key words: treatment order, infection, fracture

SKU: JSOA-2022-31-3-9 Categories: , Tags: , ,

Olivia Rice, MD; Alicia Williams, MPH; Louis Lewandowski, MD; Tamar Roomian, MS, MPH;
Joseph R. Hsu, MD1; and EMIT*

EMIT: Susan Odum, PhD; Meghan K. Wally, PhD; Rachel B. Seymour, PhD; Kristina Neri, BS;
Matthew Morris, BA; Michael Bosse, MD; Madhav Karunakar, MD; Laurence Kempton, MD;
Kevin Phelps, MD, Stephen Sims, MD