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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 uppdaterad av: 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)

Studieöversikt

Status

Har inte rekryterat ännu

Betingelser

Studietyp

Observationell

Inskrivning (Beräknad)

375

Deltagandekriterier

Forskare letar efter personer som passar en viss beskrivning, så kallade behörighetskriterier. Några exempel på dessa kriterier är en persons allmänna hälsotillstånd eller tidigare behandlingar.

Urvalskriterier

Åldrar som är berättigade till studier

18 år och äldre (Vuxen, Äldre vuxen)

Tar emot friska volontärer

Nej

Kön som är behöriga för studier

Allt

Testmetod

Sannolikhetsprov

Studera befolkning

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

Beskrivning

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

Det här avsnittet ger detaljer om studieplanen, inklusive hur studien är utformad och vad studien mäter.

Hur är studien utformad?

Designdetaljer

  • Observationsmodeller: COHORT
  • Tidsperspektiv: PROSPECTIVE

Kohorter och interventioner

Grupp / Kohort
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

Vad mäter studien?

Primära resultatmått

Resultatmått
Åtgärdsbeskrivning
Tidsram
Incidence of fracture-related infection
Tidsram: 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

Samarbetspartners och utredare

Det är här du hittar personer och organisationer som är involverade i denna studie.

Sponsor

Studieavstämningsdatum

Dessa datum spårar framstegen för inlämningar av studieposter och sammanfattande resultat till ClinicalTrials.gov. Studieposter och rapporterade resultat granskas av National Library of Medicine (NLM) för att säkerställa att de uppfyller specifika kvalitetskontrollstandarder innan de publiceras på den offentliga webbplatsen.

Studera stora datum

Studiestart (Beräknad)

1 oktober 2026

Primärt slutförande (Beräknad)

1 oktober 2027

Avslutad studie (Beräknad)

1 december 2027

Studieregistreringsdatum

Först inskickad

26 september 2026

Först inskickad som uppfyllde QC-kriterierna

26 september 2026

Första postat (Faktisk)

1 oktober 2026

Uppdateringar av studier

Senaste uppdatering publicerad (Faktisk)

1 oktober 2026

Senaste inskickade uppdateringen som uppfyllde QC-kriterierna

26 september 2026

Senast verifierad

1 september 2026

Mer information

Termer relaterade till denna studie

Andra studie-ID-nummer

  • Incidence Fracture +Infection

Läkemedels- och apparatinformation, studiedokument

Studerar en amerikansk FDA-reglerad läkemedelsprodukt

Nej

Studerar en amerikansk FDA-reglerad produktprodukt

Nej

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