High rate of unexpected positive cultures in presumed aseptic revision of stiff shoulders after proximal humerus osteosynthesis

Akgün, Doruk; Peters, Paulina-Maria; Maziak, Nina; Plachel, Fabian; Minkus, Marvin; Moroder, Philipp

doi:10.1186/s12891-020-03430-y

Cited by 11 publications

(3 citation statements)

References 29 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Then again, Akgun et al reported a 50% rate of positive cultures in a presumed aseptic revision of proximal humerus osteosynthesis. 22,23 Regarding hip surgery, Hemmann et al 16 conducted a study to analyze the safety of a single-stage revision of Total Hip Arthroplasty (THA) in failed fixations of PFFs. They found that 10% of the cases presented with positive microbiological tests despite a lack of clinical signs of infection preoperatively.…”

Section: Discussionmentioning

confidence: 99%

High rate of undetected infections in failed osteosynthesis of pertrochanteric fractures

Coelho,

Alier,

Martínez-Diaz

et al. 2024

Journal of Orthopaedic Trauma

View full text Add to dashboard Cite

OBJECTIVE: The objective of this study was to assess the incidence of infection in patients with cut-out after PFF osteosynthesis. METHODS: Design: Retrospective cohort study. Setting: Third-level trauma center. Patient selection criteria: Patients presenting with a cut-out following proximal femur fracture (PFF) (OTA/AO 31A) osteosynthesis, between January 2007 to December 2020. Outcome Measurements: The primary outcome was infection according to EBJIS criteria. RESULTS: Sixty-seven patients presenting with a cut-out were included, with mean age of 83.3 years (range 63-96) and 51 (76.1%) were women. Of all cases, 16 (24.7%) presented a concomitant infection. The presence of concomitant infection was suspected preoperatively in only 3 of the cases. A subgroup analysis was performed between the cases with infection and those without infection, the groups being comparable in terms of demographic data and postoperative radiological criteria. Patients with underlying infection had a higher rate of surgical wound complication (56.3% vs 22%, p = 0.014) and higher rates of leukocytosis (11.560 vs 7.890, p = 0.023). Conclusion: Faced with a cut-out after osteosynthesis of a proximal femur fracture, underlying infection should be considered as a possible etiological factor. Level of evidence: Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.

show abstract

Section: Discussionmentioning

confidence: 99%

High rate of undetected infections in failed osteosynthesis of pertrochanteric fractures

Coelho,

Alier,

Martínez-Diaz

et al. 2024

Journal of Orthopaedic Trauma

View full text Add to dashboard Cite

show abstract

“…Akgün et al showed a 50% rate of unexpected positive cultures for Propionibacterium acnes in patients undergoing surgery for post-surgical stiffness after ORIF. They suggested routine evaluation in all patients undergoing revision surgery after ORIF ( 15 ).…”

Section: Pathophysiologymentioning

confidence: 99%

How to treat stiffness after proximal humeral fractures?

2023

View full text Add to dashboard Cite

Shoulder stiffness is a frequent complication after proximal humeral fractures treated with or without surgery. Shoulder stiffness is associated with high rates of absence from work and a significant financial burden for the healthcare system. Secondary stiffness is characterized by additional extracapsular adhesions, including subacromial, subcoracoid, and subdeltoid spaces, usually derived from post-fracture or post-surgical extraarticular hematomas. Several secondary causes may coexist with capsular and extracapsular adhesions decreasing the shoulder motion, such as malunion, nonunion, metalwork failure, infection, and osteoarthritis, among others. Conservative treatment, usually prescribed for primary shoulder stiffness, has shown unfavorable results in secondary stiffness, and surgical intervention may be required. Surgical interventions need to be patient-specific. Usually, open or arthroscopic fibro-arthrolysis and subacromial release are performed, together with plate removal and biceps tenotomy/tenodesis. In severe osteoarthritis, shoulder replacement may be indicated. Ruling out infection is recommended in every case.

show abstract

“…Thus, it makes sense that Cutibacterium spp. are not only common pathogens in postoperative infections after shoulder arthroscopy and arthroplasty [22][23][24][25] , but also in FRI after fracture surgery in the proximal humerus 26 .…”

Section: Pathogensmentioning

confidence: 99%

Analysis of fracture-related infections from Swedish insurance claims between 2011 and 2021

Khalili,

Tevell,

Fischer

et al. 2023

Sci Rep

View full text Add to dashboard Cite

Fracture-related infections (FRI) pose a serious complication with an incidence of 1–2%. This study aimed to analyze compensation claims submitted to The Swedish National Patient Insurance Company (LÖF) because of FRI after closed/open reduction and internal fixation (C/ORIF) in the four most common fracture sites (proximal humerus, distal radius, hip, ankle). Patients registered in the LÖF database with a suspected FRI between 2011 and 2021 were identified by matching International Classification of Diseases and procedural codes indicative of a combination of fractures to the proximal humerus, distal radius, hip and ankle, C/ORIF and infection. Medical records were reviewed for fracture sites, pathogens and complications. Data from the Swedish Fracture Register (SFR) were extracted to estimate the proportion of reported claims to the presumed number of FRI. Of 122 FRI identified in the LÖF database, 34 were after C/ORIF in the proximal humerus, 12 in the distal radius, 28 in the hip and 48 in the ankle. LÖF compensated 111 patients (91%). Median time from C/ORIF to an FRI was 3 weeks (interquartile range 2–6), and 95% of all FRI occurred within 1 year after C/ORIF. Staphylococcus aureus was the most common pathogen in patients with a distal radius, hip and ankle FRI. In contrast, Cutibacterium spp. were the most common aetiology in FRI of the proximal humerus. The total number of fractures treated with C/ORIF in the four fracture sites registered in the SFR during 2021 was 18,711. Most of the FRI patients were diagnosed within the first year after C/ORIF, and 91% of the patients received compensation. Given an expected FRI incidence of 1–2%, our estimates with extrapolated data from the SFR indicate that < 10% of affected patients applied for compensation.

show abstract

High rate of unexpected positive cultures in presumed aseptic revision of stiff shoulders after proximal humerus osteosynthesis

Cited by 11 publications

References 29 publications

High rate of undetected infections in failed osteosynthesis of pertrochanteric fractures

High rate of undetected infections in failed osteosynthesis of pertrochanteric fractures

How to treat stiffness after proximal humeral fractures?

Analysis of fracture-related infections from Swedish insurance claims between 2011 and 2021

Contact Info

Product

Resources

About