Prognostic factors for surgical site infection following intramedullary nailing of diaphyseal fractures of the femur and tibia in adult patients at a tertiary hospital in Lusaka, Zambia

Trop Doct. 2022 Jan;52(1):15-22. doi: 10.1177/00494755211064657. Epub 2021 Dec 21.

Abstract

Our study aimed to identify prognostic factors for surgical site infection following long bone fracture intramedullary nailing at a tertiary hospital in a low-resource setting. This was a longitudinal observational study involving 132 participants enrolled over a one-year period with femoral and tibial diaphyseal fractures scheduled for ORIF. Participant median age was 30 years (range: 26 - 42). The prevalence of surgical site infection was 16%. Male sex (AOR=0.26, 95% CI [0.70-0.98]; p = 0.047) was associated with lower odds of surgical site infection while associated non-musculoskeletal injuries were associated with higher odds of developing surgical site infection. Our study confirms a higher surgical site infection rate than normally accepted. However, intramedullary nailing in our setting is justified as it allows an early return to a pre-injury state. These interventions must be carried out in the best possible circumstances. Future studies could explore alternative methods of fracture fixation.

Keywords: Surgical site infection; femur; intramedullary nailing; risk factors; tibia.

Publication types

  • Observational Study

MeSH terms

  • Adult
  • Bone Nails
  • Femoral Fractures* / epidemiology
  • Femoral Fractures* / surgery
  • Femur
  • Fracture Fixation, Intramedullary* / adverse effects
  • Fracture Healing
  • Humans
  • Male
  • Prognosis
  • Surgical Wound Infection / diagnosis
  • Surgical Wound Infection / epidemiology
  • Surgical Wound Infection / etiology
  • Tertiary Care Centers
  • Tibia / surgery
  • Treatment Outcome
  • Sambia