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Table 1 Baseline characteristics of the surgery performed

From: The value of conventional radiographs for diagnosing internal fixation-associated infection

  All cases
(n = 421)
Aseptic cases
(n = 305)
Septic cases
(n = 116)
Initial indication for surgery (n, %)
 - Fracturea 333 (79.1) 238 (78.0) 95 (81.9)
 - Arthrodesis 37 (8.8) 28 (9.2) 9 (7.8)
 - Osteotomy 33 (7.8) 26 (8.5) 7 (6.0)
 - Tumor surgery 8 (1.9) 7 (2.3) 1 (0.9)
 - Instability, ligament injury 5 (1.2) 3 (1.0) 2 (1.8)
 - Other (limb lengthening, war injury) 5 (1.2) 3 (1.0) 2 (1.8)
Type of implant (n, %)
 - Plate and/or screws 325 (77.2) 239 (78.4) 86 (74.1)
 - Intramedullary nail 71 (16.9) 52 (17.0) 19 (16.4)
 - K-wires /  Elastic nails / tension band 21 (5.0) 12 (3.9) 9 (7.8)
 - Other (staple, anchor) 4 (1.0) 2 (0.6) 2 (1.8)
Indication for removal of internal fixation (n, %)
 - Infection suspected 105 (24.9) 28 (9.2) 77 (66.3)
   Chronic infectionb 72 (17.1) 22 (7.2) 50 (43.1)
   Acute / haematogenous infection 33 (7.9) 6 (2.0) 27 (23.3)
- Infection not suspected 316 (75.1) 277 (90.8) 39 (33.6)
Nonunionc 84 (20.0) 74 (24.3) 10 (8.6)
Malposition, loss of fixation 57 (13.5) 48 (15.7) 9 (7.7)
Symptomatic hardware 57 (13.5) 52 (17.0) 5 (4.3)
Osteoarthritis 31 (7.4) 27 (8.9) 4 (3.4)
Avascular necrosis 24 (5.7) 20 (6.6) 4 (3.4)
Cutout 10 (2.4) 9 (3.0) 1 (0.9)
Periimplant fracture 19 (4.5) 18 (5.9) 1 (0.9)
Hardware breakage 14 (3.3) 14 (4.6) 0 (0.0)
Joint stiffness 9 (2.1) 7 (2.3) 2 (1.7)
Planned removal 7 (1.7) 6 (2.0) 1 (0.9)
Other (Charcot, tumor progression) 4 (1.0) 2 (0.7) 2 (1.8)
Anatomical location, AO region (n, %)
 - 1: Humerus, clavicle, scapula 81 (19.2) 54 (17.7) 27 (23.3)
 - 2: Radius, ulna 41 (9.7) 31 (10.2) 10 (8.6)
 - 3: Femur, patella 121 (28,7) 101 (33.1) 20 (17.2)
 - 4: Tibia, fibula 130 (30.9) 88 (28.9) 42 (36.2)
 - 6: Pelvis, acetabulum 9 (2.1) 5 (1.6) 4 (3.5)
 - 7: Hand 1 (0.2) 0 (0.0) 1 (0.9)
 - 8: Foot 38 (9.0) 26 (8.5) 12 (10.3)
Surgery performed (n, %)
 - Implant removal 185 (43.9) 109 (35.7) 76 (65.5)
 - Reosteosynthesis 156 (37.1) 131 (43.0) 25 (21.6)
 - Arthroplasty 51 (12.1) 46 (15.1) 5 (4.3)
 - Masquelet, joint spacer 14 (3.3) 9 (3.0) 5 (4.3)
 - External fixation for nonunion 6 (1.4) 2 (0.7) 4 (3.4)
 - Dynamisation 4 (1.0) 4 (1.3) 0 (0.0)
 - Arthrodesis 3 (0.7) 3 (1.0) 0 (0.0)
 - Amputation 1 (0.2) 0 (0.0) 1 (0.9)
 - Ligament reconstruction 1 (0.2) 1 (0.3) 0 (0.0)
Diagnosis of infection (n, %)
 - No infection 279 (66.3) 279 (91.5) 0 (0.0)
 - Confirmed infection 116 (27.6) 0 (0.0) 116 (100.0)
 - Suggestive infection 26 (6.2) 26 (8.5) 0 (0.0)
Radiographic changes (n, %)
 - Radiolucent line 48 (11.4) 29 (9.5) 19 (16.4)
 - Implant breakage 52 (12.4) 43 (14.1) 9 (7.8)
 - Implant displacement 45 (10.7) 32 (10.5) 13 (11.2)
 - Periosteal reaction 30 (7.1) 16 (5.2) 14 (12.1)
 - None 298 (70.8) 218 (71.5) 80 (69.0)
  1. Note. Data are indicated as no. of cases (%)
  2. a Of the 333 fracture cases, 34 were open fractures (8.4% of the total series)
  3. b Chronic infection included non-unions in which infection was suspected
  4. c Non-unions without any suspicion of infection, ascertained by the medical history, clinical examination and tests