Is it Safe to Prep the External Fixator In Situ During Second Stage Pilon Surgical Treatment?

OBJECTIVE:To evaluate the infection rate of our protocol of prepping the external fixator in situ during definitive second stage pilon fracture open reduction internal fixation. DESIGN:Retrospective clinical investigation. SETTING:Academic Level 1 Trauma Center. PATIENTS/PARTICIPANTS:Out of 229 patients with distal tibia fractures presenting to our institution from 1999-2014, 100 were treated in a two-stage fashion utilizing this protocol. INTERVENTION:Prepping the external fixator into the surgical field during the second stage/definitive open reduction internal fixation procedure. MAIN OUTCOME MEASUREMENT:The rates of deep and superficial infections after definitive fixation. RESULTS:The deep infection rate was 13% and the superficial infection rate was 11%. CONCLUSIONS:Infection rates using this protocol are comparable to previously reported infection rates for two-stage surgical treatment of pilon fractures. This protocol provides the treating surgeon information about an alternative method to streamline definitive fixation. LEVEL OF EVIDENCE:Therapeutic Level IV.