Preoperative Diagnosis of Infection in Patients with Nonunions

• DOI: 10.2106/jbjs.l.01034
• Publication Date: 2013-08-08T05:01:48Z
• Authors: Charlton Stucken; Dana C Olszewski; William R Creevy; Akira M Murakami; Paul Tornetta
• Keywords: Erythrocyte sedimentation rate; White blood cell; Univariate analysis

The surgical treatment of a fracture nonunion is complicated in the presence infection. purpose present study to report on utility standardized protocol rule out infection high-risk patients and evaluate efficacy each component protocol.A single preoperative laboratory tests (white blood-cell count, C-reactive protein level, erythrocyte sedimentation rate) combined white blood cell/sulfur colloid scan were performed for with high risk nonunion. Infection was diagnosed basis positive intraoperative cultures, evidence gross at time procedure, or during immediate postoperative period. With use as end point, univariate analysis multiple logistic regression used compare tests. A stratification method combine tests.Ninety-three ninety-five nonunions evaluated. Thirty ultimately being infected. combination elevated rate, level scan, predicted probabilities associated zero, one, two, three 18%, 24%, 50%, 86%, respectively. elimination nuclear factors 20%, 19%, 56%, 100%.The rate both independently accurate predictors Use showed that likelihood increased additional test. least predictive revealing not cost effective, even part scheme.Diagnostic III. See instructions authors complete description levels evidence.