Abstract
Objectives
The purpose of this study was to investigate the influence of immune deficiency status of HIV-positive patients on postoperative complication such as surgical site infection and nonunions.
Design
Retrospective observational cohort study: Level III.
Setting
Level I trauma center.
Patients/participants
Consecutive adult HIV-positive patients with closed fractures who underwent operative treatment between January 1, 2001 and December 31, 2012.
Main outcome and measurements
postoperative complication including infection and fracture nonunion.
Results
A total of 42 HIV-positive patients with closed fractures who underwent surgical fracture fixation were identified during the 12-year study time window. Of these, 18 patients were excluded due to incomplete medical records (n = 16) or open fractures (n = 2). The remaining 24 patients with closed fracture treated surgically (19 males and 5 females; mean age 45.1 ± 10.5 years; age range 20–67 years) were included in the study. Within a 6-month period from the time of injury, 16 patients had a CD4+ cell count >200 and five patients had a CD4+ cell count <200 (CD4+ cell count was not available in three patients). Twenty-two patients (91.6 %) were on antiretroviral therapy at the time of injury. Only one patient, with associated end-stage renal failure and diabetes mellitus, developed a postoperative infection (4.2 %). All patients achieved fracture union within 180 days postoperatively, without the need for surgical revisions.
Conclusions
Our study suggests that HIV infection does not seem to correlate with a higher risk for the development of postoperative complication related to surgical site infection and fracture nonunions after operative fixation of closed fractures.
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Hao, J., Herbert, B., Quispe, J.C. et al. An observational case series of HIV-positive patients treated with open reduction internal fixation for a closed lower extremity fracture. Eur J Orthop Surg Traumatol 25, 815–819 (2015). https://doi.org/10.1007/s00590-015-1595-4
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DOI: https://doi.org/10.1007/s00590-015-1595-4