Orthopedic infections in equine long bone fractures and arthrodeses treated by internal fixation: 192 cases (1990-2006).
Abstract: To determine the rate of postoperative infection (POI) for internal fixation repaired equine long bone fractures and arthrodeses and identify associated risk factors. Methods: Case series. Methods: Horses (n=192) with fracture repair of the third metacarpal and metatarsal bones, radius, ulna, humerus, tibia, and femur, or arthrodesis with internal fixation. Methods: Medical records (1990-2006) were reviewed for signalment, anatomic location, fracture classification and method of repair, technique and surgical duration, bacterial species isolated, postoperative care, onset of POI, and outcome. Results: Of 192 horses (171 [89%] closed, 21 [11%] open fractures), 157 (82%) were discharged from the hospital. Infection occurred in 53 (28% horses), of which 31 (59%) were discharged. Repairs without POI were 7.25 times more likely to be discharged from the hospital. Closed fractures were 4.23 times more likely to remain uninfected and 4.59 times more likely to be discharged from the hospital compared with open fractures. Closed reduction and internal fixation was associated with a 2.5-fold reduction in rate of POI and a 5.9 times greater chance for discharge from the hospital compared with open reduction and internal fixation. Females had a strong trend for increased POI when compared with colts and stallion but not geldings. Conclusions: Overall rate of POI was 28%. Fracture classification, method of repair, gender, and surgical duration were significant risk factors.
Publication Date: 2010-04-29 PubMed ID: 20459481DOI: 10.1111/j.1532-950X.2010.00705.xGoogle Scholar: Lookup
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- Journal Article
Summary
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The research article investigates the rate of postoperative infection in horses after they undergo a surgical procedure to repair long bone fractures or carry out arthrodeses using internal fixation techniques. Additionally, the study identifies the risk factors associated with this type of infection.
Methods
- The study involved a case series of 192 horses that had undergone surgical repair for fractures of the third metacarpal and metatarsal bones, radius, ulna, humerus, tibia, and femur, or arthrodesis using internal fixation techniques.
- Researchers examined medical records spanning a period from 1990 to 2006, reviewing details such as the horse’s signalment, the anatomic location of the injury, the classification of the fracture and the method of repair, the technique used and duration of the surgery, any bacterial species isolated, the horse’s postoperative care, the onset of postoperative infection (POI), and the ultimate outcome.
Results
- Out of the 192 horses, 157 (82%) were successfully discharged from the hospital. However, 53 horses (28% of the total) developed postoperative infections, of which 31 (around 59% of the infected horses) were able to be discharged.
- Repairs without postoperative infection were over seven times more likely to result in a successful discharge from the hospital.
- Closed fractures (89% of the cases) were over four times more likely to avoid infection and be discharged successfully compared to open fractures (11% of the cases).
- Choosing closed reduction and internal fixation was associated with a 2.5-fold reduction in the rate of POI and almost six times higher chance for the horses to be discharged from the hospital compared to open reduction and internal fixation techniques.
- Females demonstrated a noticeable trend for an increased rate of POI compared with colts and stallions but not geldings.
Conclusions
- The overall rate of postoperative infection was 28% among the studied cases.
- Significant risk factors for postoperative infection were fracture classification, the method of repair, the gender of the horse, and the duration of the surgical procedure.
Cite This Article
APA
Ahern BJ, Richardson DW, Boston RC, Schaer TP.
(2010).
Orthopedic infections in equine long bone fractures and arthrodeses treated by internal fixation: 192 cases (1990-2006).
Vet Surg, 39(5), 588-593.
https://doi.org/10.1111/j.1532-950X.2010.00705.x Publication
Researcher Affiliations
- Department of Clinical Studies, New Bolton Center, School of Veterinary Medicine, University of Pennsylvania, Kennett Square, PA 19348, USA.
MeSH Terms
- Animals
- Arthrodesis / adverse effects
- Arthrodesis / veterinary
- Bone Plates / adverse effects
- Bone Plates / veterinary
- Female
- Fracture Fixation, Internal / adverse effects
- Fracture Fixation, Internal / veterinary
- Fractures, Bone / complications
- Fractures, Bone / surgery
- Fractures, Bone / veterinary
- Fractures, Closed / surgery
- Fractures, Closed / veterinary
- Fractures, Open / surgery
- Fractures, Open / veterinary
- Horse Diseases / microbiology
- Horse Diseases / surgery
- Horses / surgery
- Humans
- Male
- Risk Factors
- Surgical Wound Infection / etiology
- Surgical Wound Infection / veterinary
Citations
This article has been cited 13 times.- Mita H, Kuroda T, Niwa H, Tamura N, Fukuda K, Ohta M. Incidence of surgical site infection after internal fixation of the first phalangeal bone and the third metacarpal/metatarsal bone fractures in Thoroughbred racehorses.. J Equine Sci 2023 Sep;34(3):61-66.
- Thurston CC, Stefanovski D, MacKinnon MC, Chapman HS, Richardson DW, Levine DG. Serum amyloid A and fibrinogen as markers for early detection of surgical site infection associated with internal fixation in the horse.. Front Vet Sci 2022;9:960865.
- Daniels A, Pezzanite LM, Griffenhagen GM, Hendrickson DA. Evaluation of factors associated with surgical site infection in equine proximal interphalangeal joint arthrodesis: 54 cases (2010-2019).. Vet Med Sci 2022 Jul;8(4):1478-1488.
- Redding LE, Elzer EJ, Ortved KF. Effects of regional limb perfusion technique on concentrations of antibiotic achieved at the target site: A meta-analysis.. PLoS One 2022;17(4):e0265971.
- González-Martín M, Silva V, Poeta P, Corbera JA, Tejedor-Junco MT. Microbiological aspects of osteomyelitis in veterinary medicine: drawing parallels to the infection in human medicine.. Vet Q 2022 Dec;42(1):1-11.
- Grzeskowiak RM, Alghazali KM, Hecht S, Donnell RL, Doherty TJ, Smith CK, Anderson DE, Biris AS, Adair HS. Influence of a novel scaffold composed of polyurethane, hydroxyapatite, and decellularized bone particles on the healing of fourth metacarpal defects in mares.. Vet Surg 2021 Jul;50(5):1117-1127.
- Ribitsch I, Oreff GL, Jenner F. Regenerative Medicine for Equine Musculoskeletal Diseases.. Animals (Basel) 2021 Jan 19;11(1).
- Rocktäschel T, Renner-Martin K, Cuny C, Brehm W, Truyen U, Speck S. Surgical hand preparation in an equine hospital: Comparison of general practice with a standardised protocol and characterisation of the methicillin-resistant Staphylococcus aureus recovered.. PLoS One 2020;15(12):e0242961.
- Ball AN, Phillips JN, McIlwraith CW, Kawcak CE, Samulski RJ, Goodrich LR. Genetic modification of scAAV-equine-BMP-2 transduced bone-marrow-derived mesenchymal stem cells before and after cryopreservation: An "off-the-shelf" option for fracture repair.. J Orthop Res 2019 Jun;37(6):1310-1317.
- Lozier JW, Niehaus AJ, Muir A, Lakritz J. Short- and long-term success of transfixation pin casts used to stabilize long bone fractures in ruminants.. Can Vet J 2018 Jun;59(6):635-641.
- Isgren CM, Salem SE, Townsend NB, Timofte D, Maddox TW, Archer DC. Sequential bacterial sampling of the midline incision in horses undergoing exploratory laparotomy.. Equine Vet J 2019 Jan;51(1):38-44.
- Seo JP, Yamaga T, Tsuzuki N, Yamada K, Haneda S, Furuoka H, Tabata Y, Sasaki N. Minimally invasive proximal interphalangeal joint arthrodesis using a locking compression plate and tissue engineering in horses: a pilot study.. Can Vet J 2014 Nov;55(11):1050-6.
- Stewart S, Barr S, Engiles J, Hickok NJ, Shapiro IM, Richardson DW, Parvizi J, Schaer TP. Vancomycin-modified implant surface inhibits biofilm formation and supports bone-healing in an infected osteotomy model in sheep: a proof-of-concept study.. J Bone Joint Surg Am 2012 Aug 1;94(15):1406-15.
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