Risk factors of wound infection after open reduction and internal fixation of calcaneal fractures

The aim of this study was to investigate the risk factors of wound infection after open reduction and internal fixation of calcaneal fractures. In all, 299 patients with 318 calcaneal fractures who underwent open reduction and internal fixation by a single surgeon were grouped according to different outcomes. We gathered the data on each patient including sex, age, injury mechanism, body mass index (BMI), time to operation, fracture type, associated injuries, treatment course, tourniquet time, blood loss, bone graft (yes or no), diabetes (yes or no), smoking history, and complications. Univariate analysis and multivariable analysis were used to determine the association between risk factors and wound infection. Patients who met the entry criteria included 267 males and 32 females with a mean age of 38.6 years. Among them, 5.3% (n = 17) suffered wound infection, and all of the wounds healed after different treatments. According to the univariate analysis, the patients who developed wound infections were active smokers, more obese (higher BMI), had a longer time from injury to operation, and longer tourniquet time. Multivariate analysis indicated that a higher BMI, delayed operation, and active smoking were independent risk factors for wound infection after open reduction and internal fixation of calcaneal fractures. Patients with calcaneal fractures who were smokers and had a higher BMI had a high risk of wound infections. We suggested that surgeons wait to operate until swellings of the injured foot improved, and we also suggested the operation should be within 14 days after the injury.