Identifying Risk Factors for the Development of Infection Following Open Fracture of the Hand.

Devarasetty, V V N Manohar; Krishna, Sakshi; Saad, Mariam; Byers, Victor V; Saraf, Anouska; Hong, Julia R; Hill, J Bradford · Ann Plast Surg · 2026

retrospective_cohort · Level III

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Abstract

Open hand fractures present a substantial risk of infection, which can impede recovery and long-term function. This retrospective study evaluated 663 open hand fractures to identify factors associated with infection. The infection rate was 9.5%, with significant risk factors including Gustilo-Anderson Class II and III fractures (P < 0.001 for each) and wound contamination (P = 0.004). In contrast, no significant associations were found for sex, age, comorbidities (such as diabetes and smoking), management strategy, or choice of prophylactic antibiotics. These findings suggest that fracture severity and gross contamination may be among the most important factors in predicting infection risk.

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