Factors Associated with Infection Following Open Fracture Management

Open Access

Abstract

Background: Open fractures are associated with substantial infection risk because of soft-tissue damage, contamination and exposure of the fracture site to the external environment. Identifying modifiable risk factors is important for preventing infectious complications and improving outcomes. Methods & Materials: This prospective observational study included 230 patients with open fractures managed in the Department of Orthopaedic Surgery, 250-Bedded General Hospital, Naogaon, from November 2024 to October 2025. Patients were enrolled using consecutive sampling. Demographic, injury-related and management-related variables were recorded and infection following fracture management was assessed. Data were analyzed using IBM SPSS Statistics version 25.0. Associations were evaluated using the chi-square or Fisher's exact test, with p<0.05 considered statistically significant. Results: Most patients were aged 18-29 years (62, 27.0%), male (181, 78.7%) and from rural areas (142, 61.7%). Road traffic accidents were the leading mechanism (119, 51.7%) and tibia/fibula was the most common fracture site (94, 40.9%). Grade II fractures predominated (88, 38.3%). Infection was significantly associated with age ≥40 years (29, 25.4% vs. 19, 16.4%; p=0.041), Grade III fractures (30, 38.0% vs. 18, 11.9%; p<0.001), severe wound contamination (21, 51.2% vs. 27, 14.3%; p<0.001), delayed presentation (p=0.001), delayed antibiotic administration (p<0.001), delayed debridement (p<0.001) and diabetes mellitus (10, 47.6% vs. 38, 18.2%; p=0.004). Conclusion: Infection was significantly associated with injury severity, wound contamination, treatment delays, older age and diabetes mellitus. Early antibiotics and timely debridement may help reduce infectious complications.