Fracture-related infections (FRI) are postoperative complications that result in increased morbidity and mortality, hospital days, and costs. The study aimed to characterize the clinical-epidemiological and microbiological profile of FRIs in a tertiary hospital in Rio Grande do Sul, as well as to evaluate clinical and functional outcomes. Retrospective study analyzing FRIs diagnosed between 2017 and 2024. Demographic variables, Charlson comorbidity index, type and mechanism of fracture, time from fracture to infection diagnosis, microbiological profile, length of hospital stay, and occurrence of motor sequelae were assessed. One hundred thirty-three patients with a diagnosis of FRI were analyzed. Mean age was 41 years (SD ±15.5), and 69.2% were male. Motor vehicle accidents accounted for 73.7% of cases. Open fractures represented 60.2% of the total. Gram-negative (GN) infections represented 56.4%, being more frequent in open fractures (63.7%) compared with closed fractures (45.3%), P = 0.049. Among GN infections, 15.8% were carbapenem-resistant. Median time between fracture and infection diagnosis was 84 (26-257) days, being longer in GP vs GN infections, 128 days (50-300) vs 54 days (22-180), respectively, P = 0.007. Median length of hospital stay after GN infection was longer compared with GP infections, 32 days (21-50) vs 20 days (11-38), respectively, P = 0.021. After infection diagnosis, 130 patients (98%) required new surgical approaches, with median interventions for GN of 2 (1-5) and for GP of 1 (1-3), P = 0.085. Over a 12-month period after FRI, 53 patients (39.8%) required new hospitalizations, and those with GN infection represented 60.4% of the total, P = 0.48. Motor sequelae occurred in 90 patients (69.2%), and GN infection represented 58% of the total P = 0.71. Six (4.5%) patients underwent amputation of the affected limb. There was no record of in-hospital death. FRIs predominantly affect young, healthy individuals, victims of motor vehicle accidents, and had GN as the main cause, with a high rate of carbapenem resistance. GN bacterial infections were significantly related to earlier diagnosis and longer hospital length of stay. There was a greater number of surgical approaches and motor sequelae in patients with GN infections, although without statistical significance.
Santos et al. (2026) studied this question.