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

Background: Given its low incidence, the management of deep infection following distal radius open-reduction internal fixation (ORIF) has not been well reported. In an effort to expand our current understanding, the purpose of this case series is to present the treatment strategies and functional outcomes associated with deep infection after distal radius ORIF. Methods: All patients with deep infections after distal radius ORIF over a ten-year period were identified and their treatment courses asessed. Results: The cohort consisted of three women and one man with an average age of 55.5 ± 17.6 years. Mean time from 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). Three patients were treated with intravenous antibiotics, while one patient was treated with oral antibiotics. Mean time from infection presentation to final clinical follow-up was 11 months (Range: 3 – 20 months). Two patients required repeat I&D. A clinical determination of successful infection eradication was made in all cases. Conclusion: The reported rate of deep infection after distal radius ORIF is less than 1%. There is no well-defined treatment algorithm for patients with deep infection after distal radius ORIF. However, removal of hardware and postoperative oral or intravenous antibiotic therapy appears effective, and is consistent with the standard practices of treating infection after other orthopaedic surgeries.