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Incidence of Fracture-Related Infection Among Adult Trauma Patients Undergoing Operative Fracture Fixation A Prospective Cohort Study at the Orthopaedic and Trauma Surgery Unit, Assiut University Hospital

26. september 2026 opdateret af: Ahmed Osama Ali Galal, Assiut University

Fracture-related infection (FRI) is an infection occurring after operative or non-operative management of a fracture, and it represents one of the most serious complications encountered in orthopaedic trauma surgery. In 2018, an international expert group convened by the AO Foundation and the European Bone and Joint Infection Society (EBJIS) published a consensus definition for FRI, establishing standardized confirmatory and suggestive diagnostic criteria to overcome the historical absence of a uniform case definition, which had previously hampered both clinical practice and comparability of research in this field.

  • FRI can complicate both open and closed fractures treated by internal or external fixation. Its clinical spectrum ranges from early post-operative wound infection to chronic, recalcitrant post traumatic osteomyelitis, fracture non-union and, in severe cases, amputation of the affected limb.
  • The burden of FRI is multidimensional and falls on the patient, the treating surgical team, and the wider community

Reported incidence of FRI varies widely according to fracture type, anatomical site and host/injury-severity factors. Pooled estimates from the literature suggest an overall incidence of approximately 0.4-16% across all operatively treated fractures: closed fractures carry a substantially lower risk (approximately 1-2%) than open fractures, in which incidence commonly exceeds 15% and rises further with increasing severity of soft-tissue and bony injury.

A large multicentre cohort from India applying prospective follow-up reported an overall infection incidence of 2.9% (1.6% in closed and 8.0% in open tibial fractures)

. Risk is further modulated by patient-related factors (diabetes mellitus, smoking, obesity, immunosuppression), injury related factors (high-energy mechanism, soft-tissue compromise, contamination) and treatment related factors (timing of antibiotic prophylaxis and surgical debridement, type of fixation, duration of surgery)

Studieoversigt

Status

Ikke rekrutterer endnu

Betingelser

Undersøgelsestype

Observationel

Tilmelding (Anslået)

375

Deltagelseskriterier

Forskere leder efter personer, der passer til en bestemt beskrivelse, kaldet berettigelseskriterier. Nogle eksempler på disse kriterier er en persons generelle helbredstilstand eller tidligere behandlinger.

Berettigelseskriterier

Aldre berettiget til at studere

18 år og ældre (Voksen, Ældre voksen)

Tager imod sunde frivillige

Ingen

Køn, der er berettiget til at studere

Alle

Prøveudtagningsmetode

Sandsynlighedsprøve

Studiebefolkning

patient with Open or closed fracture of the appendicular skeleton (long bones, hand, foot, pelvis/acetabulum) requiring operative fixation in the trauma theatre of the unit

Beskrivelse

Inclusion Criteria:

  • Open or closed fracture of the appendicular skeleton (long bones, hand, foot, pelvis/acetabulum) requiring operative fixation in the trauma theatre of the unit
  • Surgery performed at the Orthopaedic and Trauma Surgery Unit, Assiut University Hospital, during the study period
  • Patient (or legal guardian, where temporary incapacity precludes immediate consent) willing and able to provide informed consent and to participate in scheduled follow-up

Exclusion Criteria:

  • Pathological fractures secondary to malignancy or to metabolic bone disease other than simple osteoporosis (different infection biology and risk profile)

    • Periprosthetic fractures, or fractures around a pre-existing implant/prosthesis (risk of misclassification with periprosthetic joint infection, which has its own distinct consensus definition)
    • Fractures of the skull, and of the cervical, thoracic or lumbar spine (excluded by precedent in the FRI validation literature, given differing anatomy, infection biology and applicability of the consensus criteria)
    • Patients presenting with infection already established at the fracture site prior to, or at the time of, the index surgery at our unit (e.g., late transfer from another facility with a pre existing diagnosis of infection) - excluded to preserve ascertainment of incident (new) rather than prevalent infection
    • Fractures managed non-operatively (conservatively)
    • Death within 48 hours of surgery from a cause unrelated to infection, precluding any meaningful infection follow-up
    • Non-resident patients (e.g., without a reliable local follow-up address) in whom completion of the minimum follow-up period cannot reasonably be assured

Studieplan

Dette afsnit indeholder detaljer om studieplanen, herunder hvordan undersøgelsen er designet, og hvad undersøgelsen måler.

Hvordan er undersøgelsen tilrettelagt?

Design detaljer

  • Observationsmodeller: COHORT
  • Tidsperspektiver: PROSPECTIVE

Kohorter og interventioner

Gruppe / kohorte
study group

Adults aged ≥18 years with Open or closed fracture of the appendicular skeleton (long bones, hand, foot, pelvis/acetabulum) requiring operative fixation in the trauma theatre of the unit

Hvad måler undersøgelsen?

Primære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Incidence of fracture-related infection
Tidsramme: within 12 months of the index operative fixation

Incidence of fracture-related infection, diagnosed using the international FRI consensus criteria in Trauma unit assiut university hospital, expressed as a proportion (%) with 95% confidence interval - overall, and stratified by fracture type (open/closed) and Gustilo-Anderson grade for open fractures.

within 12 months of the index operative fixation

Samarbejdspartnere og efterforskere

Det er her, du vil finde personer og organisationer, der er involveret i denne undersøgelse.

Sponsor

Datoer for undersøgelser

Disse datoer sporer fremskridtene for indsendelser af undersøgelsesrekord og resumeresultater til ClinicalTrials.gov. Studieregistreringer og rapporterede resultater gennemgås af National Library of Medicine (NLM) for at sikre, at de opfylder specifikke kvalitetskontrolstandarder, før de offentliggøres på den offentlige hjemmeside.

Studer store datoer

Studiestart (Anslået)

1. oktober 2026

Primær færdiggørelse (Anslået)

1. oktober 2027

Studieafslutning (Anslået)

1. december 2027

Datoer for studieregistrering

Først indsendt

26. september 2026

Først indsendt, der opfyldte QC-kriterier

26. september 2026

Først opslået (Faktiske)

1. oktober 2026

Opdateringer af undersøgelsesjournaler

Sidste opdatering sendt (Faktiske)

1. oktober 2026

Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier

26. september 2026

Sidst verificeret

1. september 2026

Mere information

Begreber relateret til denne undersøgelse

Andre undersøgelses-id-numre

  • Incidence Fracture +Infection

Lægemiddel- og udstyrsoplysninger, undersøgelsesdokumenter

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