Table 2.
Patient, trauma, fracture, perioperative characteristics and incidence of deep and superficial wound infections in 191 patients with unilateral calcaneal fractures treated with ORIF by an ELA
| No. of X patients (%) | Deep wound infection | p value (two-sided) | Superficial + deep wound infection | p value (two-sided) | |
|---|---|---|---|---|---|
| Patient characteristics | |||||
| Male | 131/191 (68.6 %) | 19 | NS | 32 | NS |
| Age (median in years) | 45 (12–75) | 45.1 | NS | 46.7 | NS |
| BMI (kg/m2) | 24.0 (16.6–38.3) | 24.4 | NS | 24.6 | NS |
| No insurance | 13/191 (6.8 %) | 1 | NS | 3 | NS |
| Past medical history | NS | NS | |||
| Psychiatric | 24/191 (12.6 %) | 3 | NS | 6 | NS |
| Cardiac | 18/191 (9.4 %) | 1 | NS | 4 | NS |
| Pulmonary | 13/191 (6.8 %) | 3 | NS | 5 | NS |
| Peripheral vascular disease | 1/191 (0.5 %) | 0 | NS | 0 | NS |
| Diabetes mellitus | 12/191 (6.3 %) | 3 | NS | 4 | NS |
| ASA classificationa | 0.001 | ||||
| 1 | 131 (68.6 %) | 14 | 24 | ||
| 2 | 55 (28.8 %) | 12 | 23 | ||
| 3 | 5 (2.6 %) | 0 | 1 | ||
| Substance abuse | NS | ||||
| Nicotine | 85/182 (46.7 %) | 11 | NS | 22 | NS |
| Drugs | 34/182 (19.8 %) | 3 | NS | 10 | NS |
| Alcohol | 103/174 (59.2 %) | 10 | 24 | NS | |
| Hospital stay | |||||
| Preoperative inpatient management | 49/191 (25.7 %) | 8 | NS | 15 | NS |
| Post-operative time to discharge (mean in days) | 4 (1–60) | 8.9 | 0.005 | 7.1 | <0.001 |
| Trauma characteristics | |||||
| LET | 91/173 (52.6 %) | 11 | NS | 25 | NS |
| Trauma mechanism | NS | NS | |||
| Fall from height | 124/191 (65.3 %) | ||||
| Fall from stairs | 40/191 (20.9 %) | ||||
| MVA | 8/191 (4.2 %) | ||||
| Direct trauma | 5/191 (2.6 %) | ||||
| Unknown/other | 14/191 (7.3 %) | ||||
| Polytrauma, ISS ≥16 | 13/191 (6.8 %) | 1 | NS | 2 | NS |
| Fracture characteristics | |||||
| Right | 101/191 (52.9 %) | 14 | NS | 29 | NS |
| Concomitant foot or lower leg fracture | 21/191 (11.0 %) | 5 | NS | 8 | NS |
| Essex-Lopresti classification | 181 | NS | NS | ||
| Joint depression type | 99/181 (54.7 %) | 13 | 28 | ||
| Tongue type | 76/181 (42.0 %) | 13 | 19 | ||
| Combined type | 3/181 (1.7 %) | 0 | 0 | ||
| Sanders classification | 183 | NS | NS | ||
| I | 17/183 (9.3 %) | 0 | 4 | ||
| II | 121/183 (66.1 %) | 19 | 30 | ||
| III | 39/183 (21.3 %) | 11 | 11 | ||
| IV | 2/183 (1.1 %) | 2 | 2 | ||
| Perioperative characteristics | |||||
| Time to surgery (days) | 14 (1–37) | 14.5 | NS | 14.5 | NS |
| Surgery within 1 week | 20/191 (10.5 %) | 5 | NS | 5 | NS |
| Surgery within 2 weeks | 98/191 (51.3 %) | 13 | NS | 24 | NS |
| Surgery within 3 weeks | 170/191 (89.0 %) | 22 | NS | 41 | NS |
| Surgery time (min) | 115 (68–231) | 123 | NS | 115 | NS |
| Single senior surgeon | 159/191 (83.2 %) | 19 | NS | 38 | NS |
| Use of tourniquet during surgery | 10/186 (5.4 %) | 2 | NS | 4 | NS |
| Duration of use (min) | 123 (90–180) | NA | NA | 180 | NS |
| Use of closed suction drain | 99/185 (53.6 %) | 10 | NS | 15 | 0.002 |
| Incision closure technique | 182 | NS | NS | ||
| Single layer | 130/182 (71.4 %) | 16 | 32 | ||
| Double layer | 52/182 (28.6 %) | 8 | 13 | ||
| Böhler’s angle | |||||
| Preoperative angle (°) | 7.4 (−43.0 to 39.4) | NS | NS | NS | NS |
| Increase in angle (°) | 23.5 (−9.3 to 75.6) | NS | NS | NS | NS |
ORIF open reduction and internal fixation, ELA extended lateral approach, NS not significant, BMI body mass index, ASA American Society of Anesthesiologists, LET low-energy trauma, MVA motor vehicle accident, ISS Injury Severity Score, NA not available
aDifference between ASA 1 and 2+3 (χ2)