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Meta-Analysis
. 2022 Mar 1;36(3):111-117.
doi: 10.1097/BOT.0000000000002259.

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  1 , Samuel S Ornell  1 , Jose M G Naranjo  1 , Nicholas Morton-Gonzaba  2 , Patrick Ryan  3 , Matthew Petershack  4 , Luis M Salazar  3 , Alvaro Moreira  4 , Boris A Zelle  1
Affiliations
Meta-Analysis

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 et al. J Orthop Trauma. .

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.

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Conflict of interest statement

B. A. Zelle has consulted for 3M KCI Inc, USA and DepuySynthes and received compensation. B. A. Zelle has also received speaker fees from AO North America. B. A. Zelle has received research grants from DepuySynthes, 3M KCI Inc, Department of Defense, and the Orthopaedic Trauma Association. B. A. Zelle has received educational grants from AO North America, Arthrex, COTA, and Smith and Nephew Inc. He serves on the editorial boards of Brazilian Journal of Orthopaedics, International Orthopaedics, Journal of Bone and Joint Surgery, Journal of Orthopaedic Trauma, and Patient Safety in Surgery. None of these activities are related to the content of this article. The remaining authors report no conflict of interest.

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