{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,9]],"date-time":"2026-04-09T23:04:16Z","timestamp":1775775856515,"version":"3.50.1"},"reference-count":17,"publisher":"Georg Thieme Verlag KG","issue":"01","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Knee Surg"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Tibial plateau fractures account for approximately 1% of all fractures and normally occur as low- or high-energy injuries. This study aims to assess risk factors for site infection following external fixation and osteosynthesis of patients with tibial plateau fracture. A retrospective study was conducted involving the records of patients with Schatzker types I, II, III, IV, V, and VI tibial plateau fractures submitted to external fixation by the emergency ward staff, followed by internal fixation with definitive osteosynthesis after improvement of the soft tissues by the knee surgery team. The following data were collected: energy of fracture, presence\/absence of exposed fracture, time between injury and emergency care, time between external fixation and definitive osteosynthesis, comorbidities, number of access routes, duration of surgery, number of participants in surgery, type of surgeon (resident or professor), distance from Schanz screws to focus of the fracture, type of fracture according to the Schatzker classification, and patient age. Among the 137 patients studied, mean age was 43.4\u2009\u00b1\u200913.8 years, 72.9% were male, 5.1% had diabetes; 43% had Schatzker VI tibial fracture; 82.4% of the fractures were caused by high-energy trauma; 90.5% had closed fractures; 100% used an external fixator prior to definitive osteosynthesis; and 49.6% had dual surgical access (medial and lateral). The prevalence of infection at the surgical site was 19.7%. In the comparison of patients with and without infection, a significant difference was found in the distance between the Schanz screws and focus of fracture (p\u2009=\u20090.0093), which was smaller in patients with infection at the surgical site. A longer time of external fixator use was also associated with the occurrence of infection at the surgical site (p\u2009=\u20090.0283). In conclusion, the positioning of Schanz screw that is an important factor for infection of surgical site, with risk of infection higher in individuals with screws closer to the focus of fracture. Duration of external fixator use may also increase risk of infection after definitive osteosynthesis.<\/jats:p>","DOI":"10.1055\/a-2664-7448","type":"journal-article","created":{"date-parts":[[2025,8,14]],"date-time":"2025-08-14T22:57:54Z","timestamp":1755212274000},"page":"044-049","source":"Crossref","is-referenced-by-count":1,"title":["Risk Factors for Surgical Site Infection following External Fixation and Osteosynthesis of Patients with Tibial Plateau Fracture"],"prefix":"10.1055","volume":"39","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1269-003X","authenticated-orcid":false,"given":"Jos\u00e9 Eduardo N.","family":"Forni","sequence":"additional","affiliation":[{"name":"Department of Orthopedics and Traumatology, S\u00e3o Jos\u00e9 do Rio Preto Medical School (FAMERP), S\u00e3o Jos\u00e9 do Rio Preto, S\u00e3o Paulo, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Caio Henrique N.","family":"Rabesquine","sequence":"additional","affiliation":[{"name":"Department of Orthopedics and Traumatology, S\u00e3o Jos\u00e9 do Rio Preto Medical School (FAMERP), S\u00e3o Jos\u00e9 do Rio Preto, S\u00e3o Paulo, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wahi","family":"Jalikj","sequence":"additional","affiliation":[{"name":"Department of Orthopedics and Traumatology, S\u00e3o Jos\u00e9 do Rio Preto Medical School (FAMERP), S\u00e3o Jos\u00e9 do Rio Preto, S\u00e3o Paulo, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2025,8,14]]},"reference":[{"issue":"10","key":"ref1","doi-asserted-by":"crossref","first-page":"1","DOI":"10.12968\/hmed.2020.0339","article-title":"Tibial plateau fracture: anatomy, diagnosis and management","volume":"81","author":"B Rudran","year":"2020","journal-title":"Br J Hosp Med 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Li","year":"2020","journal-title":"J Orthop Surg Res"},{"issue":"07","key":"ref5","doi-asserted-by":"crossref","first-page":"1501","DOI":"10.1016\/j.injury.2016.04.011","article-title":"Risk factors for infection after operative fixation of Tibial plateau fractures","volume":"47","author":"A M Momaya","year":"2016","journal-title":"Injury"},{"issue":"02","key":"ref6","doi-asserted-by":"crossref","first-page":"85","DOI":"10.1097\/BOT.0000000000000203","article-title":"Complications of high-energy bicondylar tibial plateau fractures treated with dual plating through 2 incisions","volume":"29","author":"M R Ruffolo","year":"2015","journal-title":"J Orthop Trauma"},{"issue":"09","key":"ref7","doi-asserted-by":"crossref","first-page":"e196","DOI":"10.1097\/BOT.0b013e318284704e","article-title":"Risk factors of infection after ORIF of bicondylar tibial plateau fractures","volume":"27","author":"B J Morris","year":"2013","journal-title":"J Orthop 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infections following orthopedic surgery at a community hospital and a university hospital: adverse quality of life, excess length of stay, and extra cost","volume":"23","author":"J D Whitehouse","year":"2002","journal-title":"Infect Control Hosp Epidemiol"},{"issue":"01","key":"ref12","doi-asserted-by":"crossref","first-page":"481","DOI":"10.1186\/s12891-017-1847-z","article-title":"Infection following fractures of the proximal tibia - a systematic review of incidence and outcome","volume":"18","author":"R Henkelmann","year":"2017","journal-title":"BMC Musculoskelet Disord"},{"key":"ref13","doi-asserted-by":"crossref","first-page":"649","DOI":"10.1097\/00005131-200411000-00001","article-title":"Complications associated with internal fixation of high-energy bicondylar tibial plateau fractures utilizing a two-incision technique","volume":"18","author":"D P Barei","year":"2004","journal-title":"J Orthop Trauma"},{"key":"ref14","first-page":"12","article-title":"Cost-effectiveness analysis of Schatzker V tibial plateau fractures treated with locking plate in a university hospital","volume":"10","author":"J EN Forni","year":"2021","journal-title":"Int J Sci"},{"issue":"06","key":"ref15","doi-asserted-by":"crossref","first-page":"1397","DOI":"10.1007\/s00264-017-3729-2","article-title":"Incidence and risk factors for surgical site infection following open reduction and internal fixation of adult tibial plateau fractures","volume":"42","author":"J Li","year":"2018","journal-title":"Int Orthop"},{"issue":"02","key":"ref16","doi-asserted-by":"crossref","first-page":"249","DOI":"10.1016\/j.injury.2012.10.032","article-title":"Prolonged operative time increases infection rate in tibial plateau fractures","volume":"44","author":"M Colman","year":"2013","journal-title":"Injury"},{"issue":"06","key":"ref17","doi-asserted-by":"crossref","first-page":"982","DOI":"10.1111\/iwj.12743","article-title":"Incidence and risks for surgical site infection after adult tibial plateau fractures treated by ORIF: a prospective multicentre study","volume":"14","author":"Y Zhu","year":"2017","journal-title":"Int Wound J"}],"container-title":["The Journal of Knee 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