Deep Infection after Distal Radius Open-reduction Internal Fixation: A Case Series

Document Type : RESEARCH PAPER


1 Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA, USA

2 Rothman Orthopaedic Institute, Philadelphia, PA, USA


Background: Given its low incidence, the management of deep infection following distal radius open-reduction internal
fixation (ORIF) has not been well reported. In an effort to expand our current understanding, the purpose of this case
series is to present the treatment strategies and functional outcomes associated with deep infection after distal radius
Methods: All patients with deep infections after distal radius ORIF over a ten-year period were identified and their
treatment courses asessed.
Results: The cohort consisted of three women and one man with an average age of 55.5 ± 17.6 years. Mean time
from infection presentation to irrigation and debridement (I&D) with removal of hardware (ROH) was 16 days (Range:
3 – 44 days). The identified bacterial species in all cases was Staphylococcus aureus (MRSA = 2, MSSA = 2). Three
patients were treated with intravenous antibiotics, while one patient was treated with oral antibiotics. Mean time from
infection presentation to final clinical follow-up was 11 months (Range: 3 – 20 months). Two patients required repeat
I&D. A clinical determination of successful infection eradication was made in all cases.
Conclusion: The reported rate of deep infection after distal radius ORIF is less than 1%. There is no well-defined
treatment algorithm for patients with deep infection after distal radius ORIF. However, removal of hardware and postoperative
oral or intravenous antibiotic therapy appears effective, and is consistent with the standard practices of
treating infection after other orthopaedic surgeries.
Level of evidence: IV


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