Risk Factors and Predictors of Surgical Site Infection Following Operative Treatment of Tibial Plateau Fractures: A Retrospective Cohort Study-100 cases

Abstract

Background: Tibial plateau fractures frequently require operative fixation and may be complicated by surgical site infection (SSI). Identifying risk factors can facilitate perioperative risk stratification and prevention. Objective: To determine the incidence and independent predictors of SSI following operative treatment of tibial plateau fractures. Methods: This retrospective cohort study included 100 consecutive adult patients who underwent operative treatment for tibial plateau fractures at Kurmitola Multicare Specialized Hospital, Dhaka, Bangladesh, between January and December 2025. Demographic, clinical, fracture-related and operative variables were analyzed. SSI was classified as superficial or deep. Univariable and multivariable logistic regression analyses were performed, with odds ratios (ORs) and 95% confidence intervals (CIs). Results: SSI occurred in 9 (9.0%) patients, including 5 (5.0%) superficial and 4 (4.0%) deep infections. Open fracture, compartment syndrome, hypoalbuminemia and operative duration ≥180 minutes were significantly associated with SSI and remained independent predictors in multivariable analysis. Adjusted ORs were 5.72 (95% CI 1.18–27.71) for open fracture, 6.91 (95% CI 1.40–34.10) for compartment syndrome, 4.83 (95% CI 1.09–21.41) for hypoalbuminemia and 4.96 (95% CI 1.20–20.55) for prolonged operative duration. Conclusion: SSI occurred in 9% of patients following operative treatment of tibial plateau fractures. Open fracture, compartment syndrome, hypoalbuminemia and prolonged operative duration were independent predictors. Early risk identification, soft-tissue management, nutritional optimization and meticulous perioperative care may help reduce SSI.

Keywords: Tibial Plateau Fracture; Surgical Site Infection; Risk Factors; Predictors; Open Reduction and Internal Fixation; Orthopaedic Trauma.