Deep Infection after Distal Radius Open-reduction Internal Fixation: A Case Series

Given its low incidence, the management of deep infection following distal radius open-reduction internalfixation (ORIF) has not been well reported. In an effort to expand our current understanding, the purpose of this caseseries is to present the treatment strategies and functional outcomes associated with deep infection after distal radiusORIF. All patients with deep infections after distal radius ORIF over a ten-year period were identified and theirtreatment courses asessed. The cohort consisted of three women and one man with an average age of 55.5 ± 17.6 years. Mean timefrom infection presentation to irrigation and debridement (I&D) with removal of hardware (ROH) was 16 days (Range:3 – 44 days). The identified bacterial species in all cases was Staphylococcus aureus (MRSA = 2, MSSA = 2). Threepatients were treated with intravenous antibiotics, while one patient was treated with oral antibiotics. Mean time frominfection presentation to final clinical follow-up was 11 months (Range: 3 – 20 months). Two patients required repeatI&D. A clinical determination of successful infection eradication was made in all cases. The reported rate of deep infection after distal radius ORIF is less than 1%. There is no well-definedtreatment algorithm for patients with deep infection after distal radius ORIF. However, removal of hardware and postoperativeoral or intravenous antibiotic therapy appears effective, and is consistent with the standard practices oftreating infection after other orthopaedic surgeries.Level of evidence: IV