{
    "abstract": "Management of infection on internal fixation hardware is particularly complex. The main aim of the present study was to assess bone consolidation rates under septic conditions in patients treated for bone and joint infection (BJI) with hardware retention. Secondary objectives were to determine a time limit beyond which it is unreasonable to retain hardware, and to assess risk factors for non-consolidation and functional results. The study hypothesis was that bone consolidation is possible under septic conditions without hardware exchange.\nA single-center retrospective observational study was conducted on 69 patients for the period January 1, 2009 to December 31, 2019. We included all patients aged over 15 years with infection after internal fixation or fusion whose files had been discussed in the multidisciplinary team meeting during the study period. Bone healing was screened for on X-ray or CT. Study data comprised type of fracture, smoking status, time to treatment for open fracture, initial surgery time, type of hardware, interval between fixation and revision, and type of irrigation. Functional results were assessed at follow-up: walking, pain, return to work and SF12 and QuickDASH scores.\nThe bone healing rate was 73.5% (50/68 patients) at a mean 24 weeks (range, 6-68 weeks). Time to revision did not significantly impact consolidation: 60% for 2 weeks (6/10 cases), 80% for 2-10 weeks (35/40 cases), and 64% for >10 weeks (9/14 cases) (p\u2009=\u20090.28). Smoking, longer initial surgery time and Gustilo type IIIb or IIIc were significant risks factors for non-consolidation.\nBone consolidation under septic conditions with hardware retention adhering to an established medical and surgical protocol was reliable and straightforward, without extra morbidity. These findings are encouraging, and in line with the literature. We were unable to determine a time limit beyond which hardware prevented healing.\nIV; descriptive epidemiological study.",
    "authors": [
        {
            "affiliation": "Service d'Orthop\u00e9die, de Traumatologie, de Chirurgie Plastique, Reconstructrice et Assistance Main, Universit\u00e9 de Franche-Comt\u00e9, Facult\u00e9 de M\u00e9decine et CHU de Besan\u00e7on LNIT (UR 4662), F-25000 Besan\u00e7on, France. Electronic address: adabert@chu-besancon.fr.",
            "firstname": "Aliz\u00e9",
            "initials": "A",
            "lastname": "Dabert"
        },
        {
            "affiliation": "Service d'Orthop\u00e9die, de Traumatologie, de Chirurgie Plastique, Reconstructrice et Assistance Main, Universit\u00e9 de Franche-Comt\u00e9, Facult\u00e9 de M\u00e9decine et CHU de Besan\u00e7on LNIT (UR 4662), F-25000 Besan\u00e7on, France.",
            "firstname": "Adrien",
            "initials": "A",
            "lastname": "Runtz"
        },
        {
            "affiliation": "Service d'Orthop\u00e9die, de Traumatologie, de Chirurgie Plastique, Reconstructrice et Assistance Main, Universit\u00e9 de Franche-Comt\u00e9, Facult\u00e9 de M\u00e9decine et CHU de Besan\u00e7on LNIT (UR 4662), F-25000 Besan\u00e7on, France.",
            "firstname": "Gr\u00e9goire",
            "initials": "G",
            "lastname": "Leclerc"
        },
        {
            "affiliation": "Service d'Orthop\u00e9die, de Traumatologie, de Chirurgie Plastique, Reconstructrice et Assistance Main, Universit\u00e9 de Franche-Comt\u00e9, Facult\u00e9 de M\u00e9decine et CHU de Besan\u00e7on LNIT (UR 4662), F-25000 Besan\u00e7on, France.",
            "firstname": "Pauline",
            "initials": "P",
            "lastname": "Sergent"
        },
        {
            "affiliation": "Service d'Orthop\u00e9die, de Traumatologie, de Chirurgie Plastique, Reconstructrice et Assistance Main, Universit\u00e9 de Franche-Comt\u00e9, Facult\u00e9 de M\u00e9decine et CHU de Besan\u00e7on LNIT (UR 4662), F-25000 Besan\u00e7on, France; Laboratoire de Nanom\u00e9decine, Imagerie et Th\u00e9rapeutique EA4662, Universit\u00e9 Bourgogne Franche-Comt\u00e9, F-25000 Besan\u00e7on, France.",
            "firstname": "Fran\u00e7ois",
            "initials": "F",
            "lastname": "Loisel"
        },
        {
            "affiliation": "Service d'Orthop\u00e9die, de Traumatologie, de Chirurgie Plastique, Reconstructrice et Assistance Main, Universit\u00e9 de Franche-Comt\u00e9, Facult\u00e9 de M\u00e9decine et CHU de Besan\u00e7on LNIT (UR 4662), F-25000 Besan\u00e7on, France; Laboratoire de Nanom\u00e9decine, Imagerie et Th\u00e9rapeutique EA4662, Universit\u00e9 Bourgogne Franche-Comt\u00e9, F-25000 Besan\u00e7on, France.",
            "firstname": "Isabelle",
            "initials": "I",
            "lastname": "Pluvy"
        },
        {
            "affiliation": "Service d'Orthop\u00e9die, de Traumatologie, de Chirurgie Plastique, Reconstructrice et Assistance Main, Universit\u00e9 de Franche-Comt\u00e9, Facult\u00e9 de M\u00e9decine et CHU de Besan\u00e7on LNIT (UR 4662), F-25000 Besan\u00e7on, France.",
            "firstname": "Thomas",
            "initials": "T",
            "lastname": "Fradin"
        },
        {
            "affiliation": "Service d'Orthop\u00e9die, de Traumatologie, de Chirurgie Plastique, Reconstructrice et Assistance Main, Universit\u00e9 de Franche-Comt\u00e9, Facult\u00e9 de M\u00e9decine et CHU de Besan\u00e7on LNIT (UR 4662), F-25000 Besan\u00e7on, France.",
            "firstname": "Patrick",
            "initials": "P",
            "lastname": "Garbuio"
        }
    ],
    "conclusions": null,
    "copyrights": "Copyright \u00a9 2024 Elsevier Masson SAS. All rights reserved.",
    "doi": "10.1016/j.otsr.2024.103942",
    "journal": "Orthopaedics & traumatology, surgery & research : OTSR",
    "keywords": [
        "Bone",
        "Fracture",
        "Fracture fixation",
        "Fracture healing",
        "Osteitis",
        "Surgical wound infection"
    ],
    "methods": null,
    "publication_date": "2024-07-20",
    "pubmed_id": "39030127",
    "results": "The bone healing rate was 73.5% (50/68 patients) at a mean 24 weeks (range, 6-68 weeks). Time to revision did not significantly impact consolidation: 60% for 2 weeks (6/10 cases), 80% for 2-10 weeks (35/40 cases), and 64% for >10 weeks (9/14 cases) (p\u2009=\u20090.28). Smoking, longer initial surgery time and Gustilo type IIIb or IIIc were significant risks factors for non-consolidation.",
    "title": "Bone consolidation under septic condition and hardware retention: about 69 patients.",
    "xml": "<Element 'PubmedArticle' at 0x788505707880>"
}