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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

2026年9月26日 更新者：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)

研究概览

地位

尚未招聘

条件

研究类型

观察性的

注册 (估计的)

375

参与标准

研究人员寻找符合特定描述的人，称为资格标准。这些标准的一些例子是一个人的一般健康状况或先前的治疗。

资格标准

适合学习的年龄

18年 及以上 (成人、年长者)

接受健康志愿者

不

有资格学习的性别

全部

取样方法

概率样本

研究人群

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

描述

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

学习计划

本节提供研究计划的详细信息，包括研究的设计方式和研究的衡量标准。

研究是如何设计的？

设计细节

  • 观测模型：COHORT
  • 时间观点：PROSPECTIVE

队列和干预

团体/队列
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

研究衡量的是什么？

主要结果指标

结果测量
措施说明
大体时间
Incidence of fracture-related infection
大体时间：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

合作者和调查者

在这里您可以找到参与这项研究的人员和组织。

赞助

Assiut University

研究记录日期

这些日期跟踪向 ClinicalTrials.gov 提交研究记录和摘要结果的进度。研究记录和报告的结果由国家医学图书馆 (NLM) 审查，以确保它们在发布到公共网站之前符合特定的质量控制标准。

研究主要日期

学习开始 (估计的)

2026年10月1日

初级完成 (估计的)

2027年10月1日

研究完成 (估计的)

2027年12月1日

研究注册日期

首次提交

2026年9月26日

首先提交符合 QC 标准的

2026年9月26日

首次发布 (实际的)

2026年10月1日

研究记录更新

最后更新发布 (实际的)

2026年10月1日

上次提交的符合 QC 标准的更新

2026年9月26日

最后验证

2026年9月1日

更多信息

与本研究相关的术语

其他研究编号

  • Incidence Fracture +Infection

药物和器械信息、研究文件

研究美国 FDA 监管的药品

不

研究美国 FDA 监管的设备产品

不

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