Is It Safe to Prep the External Fixator In Situ During Second-Stage Pilon Surgical Treatment?

Abstract

To evaluate the infection rate of our protocol of prepping the external fixator in situ during definitive second-stage pilon fracture open reduction internal fixation. Retrospective clinical investigation. Academic Level 1 Trauma Center. Out of 229 patients with distal tibia fractures presenting to our institution from 1999 to 2014, 100 were treated in a 2-stage fashion utilizing this protocol. Prepping the external fixator into the surgical field during the second-stage/definitive open reduction internal fixation procedure. The rates of deep and superficial infections after definitive fixation. The deep infection rate was 13%, and the superficial infection rate was 11%. Infection rates using this protocol are comparable to previously reported infection rates for two-stage surgical treatment of pilon fractures. This protocol provides the treating surgeon information about an alternative method to streamline definitive fixation. Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.