Predicting deep infection in pilon and tibial plateau fractures: A secondary analysis of the VANCO and OXYGEN trials

Archie L. Overmann; Anthony R. Carlini; Robert V. O'Toole; Renan C. Castillo; Nathan N. O'Hara; Eben A. Carroll; James Brett Goodman; Martha B. Holden; Anna N. Miller; Amanda Spraggs-Hughes; Michael L. Brennan; Paul Tornetta; Patrick M. Osborn; Jessica C. Rivera; Clinton K. Murray; Joseph E. Kimmel; Michael J. Bosse; Joseph R. Hsu; Madhav A. Karunakar; Laurence B. Kempton; Rachel B. Seymour; Stephen H. Sims; Christine Churchill; Debra L. Sietsema; Ida Leah Gitajn; Rachel M. Reilly; Robert D. Zura; Cameron Howes; Hassan Mir; Michael J. Weaver; Marilyn Heng; Thuan V. Ly; Emily A. Wagstrom; Jerald R. Westberg; Brian H. Mullis; Jeffrey O. Anglen; Leilani S. Mullis; Karl D. Shively; Todd O. McKinley; Roman M. Natoli; Anthony Sorkin; Lauren C. Hill; Robert A. Hymes; Greg E. Gaski; A. Stephen Malekzadeh; Lolita Ramsey; Jeff E. Schulman; Cary C. Schwartzbach; Robert A. Sikorski; Olivia C. Lee; Peter C. Krause; Joshua L. Gary; Timothy S. Achor; Andrew Choo; John W. Munz; Sterling J. Boutte; Matthew C. Galpin; H. Michael Frisch; Adam M. Kaufman; C. Michael Lecroy; Christopher S. Smith; Alec C. Stall; Andrea Horne; Robert V. O'Toole; Manjari Joshi; Jason W. Nascone; Nathan N. O'Hara; Marcus F. Sciadini; Gerard P. Slobogean; Andrea L. Howe; Roman Hayda; Andrew R. Evans; Stanislaw P. Stawicki; Thomas R. Wojda; Michael J. Gardner; Julius A. Bishop; Saqib Rehman; Cyrus Caroom; Elizabeth Sheridan; Theodore Miclau; Saam Morshed; Thomas F. Higgins; Justin M. Haller; Clay A. Spitler; Massimo Max Morandi; Paul Edward Matuszewski; Arun Aneja; Patrick F. Bergin; Eldrin Bhanat; Matt L. Graves; John Morellato; David Teague; William Ertl; Jaimo Ahn; Gele B. Moloney; John C. Weinlein; Boris A. Zelle; Animesh Agarwal; Ravi A. Karia; Ashoke Sathy; Drew Sanders; David B. Weiss; Seth R. Yarboro; Veronica Lester-Ballard; Eric D. McVey; Reza Firoozabadi; Arman Dagal; Conor P. Kleweno; Julie Agel; Paul S. Whiting; Natasha M. Simske; Alexander B. Siy; William T. Obremskey; Basem Attum; Eduardo J. Burgos; Vamshi Gajari; A. Alex Jahangir; Andres Rodriguez-Buitrago; Manish Sethi; Daniel J. Stinner; Rajesh R. Tummuru; Karen M. Trochez; Jean Claude G. D'Alleyrand; Lauren E. Allen; Anthony R. Carlini; Susan C. Collins; Yanjie Huang; Tara J. Taylor

doi:10.1097/OI9.0000000000000348

Predicting deep infection in pilon and tibial plateau fractures: A secondary analysis of the VANCO and OXYGEN trials

Archie L. Overmann, Anthony R. Carlini, Robert V. O'Toole, Renan C. Castillo, Nathan N. O'Hara, Eben A. Carroll, James Brett Goodman, Martha B. Holden, Anna N. Miller, Amanda Spraggs-Hughes, Michael L. Brennan, Paul Tornetta, Patrick M. Osborn, Jessica C. Rivera, Clinton K. Murray, Joseph E. Kimmel, Michael J. Bosse, Joseph R. Hsu, Madhav A. Karunakar, Laurence B. KemptonRachel B. Seymour, Stephen H. Sims, Christine Churchill, Debra L. Sietsema, Ida Leah Gitajn, Rachel M. Reilly, Robert D. Zura, Cameron Howes, Hassan Mir, Michael J. Weaver, Marilyn Heng, Thuan V. Ly, Emily A. Wagstrom, Jerald R. Westberg, Brian H. Mullis, Jeffrey O. Anglen, Leilani S. Mullis, Karl D. Shively, Todd O. McKinley, Roman M. Natoli, Anthony Sorkin, Lauren C. Hill, Robert A. Hymes, Greg E. Gaski, A. Stephen Malekzadeh, Lolita Ramsey, Jeff E. Schulman, Cary C. Schwartzbach, Robert A. Sikorski, Olivia C. Lee, Peter C. Krause, Joshua L. Gary, Timothy S. Achor, Andrew Choo, John W. Munz, Sterling J. Boutte, Matthew C. Galpin, H. Michael Frisch, Adam M. Kaufman, C. Michael Lecroy, Christopher S. Smith, Alec C. Stall, Andrea Horne, Robert V. O'Toole, Manjari Joshi, Jason W. Nascone, Nathan N. O'Hara, Marcus F. Sciadini, Gerard P. Slobogean, Andrea L. Howe, Roman Hayda, Andrew R. Evans, Stanislaw P. Stawicki, Thomas R. Wojda, Michael J. Gardner, Julius A. Bishop, Saqib Rehman, Cyrus Caroom, Elizabeth Sheridan, Theodore Miclau, Saam Morshed, Thomas F. Higgins, Justin M. Haller, Clay A. Spitler, Massimo Max Morandi, Paul Edward Matuszewski, Arun Aneja, Patrick F. Bergin, Eldrin Bhanat, Matt L. Graves, John Morellato, David Teague, William Ertl, Jaimo Ahn, Gele B. Moloney, John C. Weinlein, Boris A. Zelle, Animesh Agarwal, Ravi A. Karia, Ashoke Sathy, Drew Sanders, David B. Weiss, Seth R. Yarboro, Veronica Lester-Ballard, Eric D. McVey, Reza Firoozabadi, Arman Dagal, Conor P. Kleweno, Julie Agel, Paul S. Whiting, Natasha M. Simske, Alexander B. Siy, William T. Obremskey, Basem Attum, Eduardo J. Burgos, Vamshi Gajari, A. Alex Jahangir, Andres Rodriguez-Buitrago, Manish Sethi, Daniel J. Stinner, Rajesh R. Tummuru, Karen M. Trochez, Jean Claude G. D'Alleyrand, Lauren E. Allen, Anthony R. Carlini, Susan C. Collins, Yanjie Huang, Tara J. Taylor

Research output: Contribution to journal › Article › peer-review

Abstract

Objectives:To develop and validate a prediction model for a deep surgical site infection (SSI) after fixation of a tibial plateau or pilon fracture.Design:Pooled data from 2 randomized trials (VANCO and OXYGEN).Setting:Fifty-two US trauma centers.Patients:In total, 1847 adult patients with operatively treated tibial plateau or pilon fractures who met criteria for a high risk of infection.Intervention:We considered 13 baseline patient characteristics and developed and externally validated prediction models using 3 approaches (logistic regression, stepwise elimination, and machine learning).Main Outcomes and Measures:The primary prediction model outcome was a deep SSI requiring operative debridement within 182 days of definitive fixation. Our primary prognostic performance metric for evaluating the models was area under the receiver operating characteristic curve (AUC) with clinical utility set at 0.7.Results:Deep SSI occurred in 75 VANCO patients (8%) and in 56 OXYGEN patients (6%). The machine learning model for VANCO (AUC = 0.65) and stepwise elimination model for OXYGEN (AUC = 0.62) had the highest internal validation AUCs. However, none of the external validation AUCs exceeded 0.64 (range, 0.58 to 0.64).Conclusions:The predictive models did not reach the prespecified clinical utility threshold. Our models' inability to distinguish high-risk from low-risk patients is likely due to strict eligibility criteria and, therefore, homogeneous patient populations.

Original language	English
Article number	e348
Journal	OTA international : the open access journal of orthopaedic trauma
Volume	7
Issue number	4
DOIs	https://doi.org/10.1097/OI9.0000000000000348
State	Published - 25 Nov 2024

Keywords

fracture related infection
infection
machine learning
pilon fracture
prediction model
surgical site infection
tibial plateau fracture

Access to Document

10.1097/OI9.0000000000000348

Cite this

Overmann, A. L., Carlini, A. R., O'Toole, R. V., Castillo, R. C., O'Hara, N. N., Carroll, E. A., Goodman, J. B., Holden, M. B., Miller, A. N., Spraggs-Hughes, A., Brennan, M. L., Tornetta, P., Osborn, P. M., Rivera, J. C., Murray, C. K., Kimmel, J. E., Bosse, M. J., Hsu, J. R., Karunakar, M. A., ... Taylor, T. J. (2024). Predicting deep infection in pilon and tibial plateau fractures: A secondary analysis of the VANCO and OXYGEN trials. OTA international : the open access journal of orthopaedic trauma, 7(4), Article e348. https://doi.org/10.1097/OI9.0000000000000348

@article{68b0f308353b4bd1bf36dd066ada007a,

title = "Predicting deep infection in pilon and tibial plateau fractures: A secondary analysis of the VANCO and OXYGEN trials",

abstract = "Objectives:To develop and validate a prediction model for a deep surgical site infection (SSI) after fixation of a tibial plateau or pilon fracture.Design:Pooled data from 2 randomized trials (VANCO and OXYGEN).Setting:Fifty-two US trauma centers.Patients:In total, 1847 adult patients with operatively treated tibial plateau or pilon fractures who met criteria for a high risk of infection.Intervention:We considered 13 baseline patient characteristics and developed and externally validated prediction models using 3 approaches (logistic regression, stepwise elimination, and machine learning).Main Outcomes and Measures:The primary prediction model outcome was a deep SSI requiring operative debridement within 182 days of definitive fixation. Our primary prognostic performance metric for evaluating the models was area under the receiver operating characteristic curve (AUC) with clinical utility set at 0.7.Results:Deep SSI occurred in 75 VANCO patients (8%) and in 56 OXYGEN patients (6%). The machine learning model for VANCO (AUC = 0.65) and stepwise elimination model for OXYGEN (AUC = 0.62) had the highest internal validation AUCs. However, none of the external validation AUCs exceeded 0.64 (range, 0.58 to 0.64).Conclusions:The predictive models did not reach the prespecified clinical utility threshold. Our models' inability to distinguish high-risk from low-risk patients is likely due to strict eligibility criteria and, therefore, homogeneous patient populations.",

keywords = "fracture related infection, infection, machine learning, pilon fracture, prediction model, surgical site infection, tibial plateau fracture",

author = "Overmann, {Archie L.} and Carlini, {Anthony R.} and O'Toole, {Robert V.} and Castillo, {Renan C.} and O'Hara, {Nathan N.} and Carroll, {Eben A.} and Goodman, {James Brett} and Holden, {Martha B.} and Miller, {Anna N.} and Amanda Spraggs-Hughes and Brennan, {Michael L.} and Paul Tornetta and Osborn, {Patrick M.} and Rivera, {Jessica C.} and Murray, {Clinton K.} and Kimmel, {Joseph E.} and Bosse, {Michael J.} and Hsu, {Joseph R.} and Karunakar, {Madhav A.} and Kempton, {Laurence B.} and Seymour, {Rachel B.} and Sims, {Stephen H.} and Christine Churchill and Sietsema, {Debra L.} and Gitajn, {Ida Leah} and Reilly, {Rachel M.} and Zura, {Robert D.} and Cameron Howes and Hassan Mir and Weaver, {Michael J.} and Marilyn Heng and Ly, {Thuan V.} and Wagstrom, {Emily A.} and Westberg, {Jerald R.} and Mullis, {Brian H.} and Anglen, {Jeffrey O.} and Mullis, {Leilani S.} and Shively, {Karl D.} and McKinley, {Todd O.} and Natoli, {Roman M.} and Anthony Sorkin and Hill, {Lauren C.} and Hymes, {Robert A.} and Gaski, {Greg E.} and Malekzadeh, {A. Stephen} and Lolita Ramsey and Schulman, {Jeff E.} and Schwartzbach, {Cary C.} and Sikorski, {Robert A.} and Lee, {Olivia C.} and Krause, {Peter C.} and Gary, {Joshua L.} and Achor, {Timothy S.} and Andrew Choo and Munz, {John W.} and Boutte, {Sterling J.} and Galpin, {Matthew C.} and Frisch, {H. Michael} and Kaufman, {Adam M.} and Lecroy, {C. Michael} and Smith, {Christopher S.} and Stall, {Alec C.} and Andrea Horne and O'Toole, {Robert V.} and Manjari Joshi and Nascone, {Jason W.} and O'Hara, {Nathan N.} and Sciadini, {Marcus F.} and Slobogean, {Gerard P.} and Howe, {Andrea L.} and Roman Hayda and Evans, {Andrew R.} and Stawicki, {Stanislaw P.} and Wojda, {Thomas R.} and Gardner, {Michael J.} and Bishop, {Julius A.} and Saqib Rehman and Cyrus Caroom and Elizabeth Sheridan and Theodore Miclau and Saam Morshed and Higgins, {Thomas F.} and Haller, {Justin M.} and Spitler, {Clay A.} and Morandi, {Massimo Max} and Matuszewski, {Paul Edward} and Arun Aneja and Bergin, {Patrick F.} and Eldrin Bhanat and Graves, {Matt L.} and John Morellato and David Teague and William Ertl and Jaimo Ahn and Moloney, {Gele B.} and Weinlein, {John C.} and Zelle, {Boris A.} and Animesh Agarwal and Karia, {Ravi A.} and Ashoke Sathy and Drew Sanders and Weiss, {David B.} and Yarboro, {Seth R.} and Veronica Lester-Ballard and McVey, {Eric D.} and Reza Firoozabadi and Arman Dagal and Kleweno, {Conor P.} and Julie Agel and Whiting, {Paul S.} and Simske, {Natasha M.} and Siy, {Alexander B.} and Obremskey, {William T.} and Basem Attum and Burgos, {Eduardo J.} and Vamshi Gajari and Jahangir, {A. Alex} and Andres Rodriguez-Buitrago and Manish Sethi and Stinner, {Daniel J.} and Tummuru, {Rajesh R.} and Trochez, {Karen M.} and D'Alleyrand, {Jean Claude G.} and Allen, {Lauren E.} and Carlini, {Anthony R.} and Collins, {Susan C.} and Yanjie Huang and Taylor, {Tara J.}",

note = "Publisher Copyright: {\textcopyright} 2024 Overmann et al. OTA International.",

year = "2024",

month = nov,

day = "25",

doi = "10.1097/OI9.0000000000000348",

language = "English",

volume = "7",

journal = "OTA international : the open access journal of orthopaedic trauma",

issn = "2574-2167",

number = "4",

}

Overmann, AL, Carlini, AR, O'Toole, RV, Castillo, RC, O'Hara, NN, Carroll, EA, Goodman, JB, Holden, MB, Miller, AN, Spraggs-Hughes, A, Brennan, ML, Tornetta, P, Osborn, PM, Rivera, JC, Murray, CK, Kimmel, JE, Bosse, MJ, Hsu, JR, Karunakar, MA, Kempton, LB, Seymour, RB, Sims, SH, Churchill, C, Sietsema, DL, Gitajn, IL, Reilly, RM, Zura, RD, Howes, C, Mir, H, Weaver, MJ, Heng, M, Ly, TV, Wagstrom, EA, Westberg, JR, Mullis, BH, Anglen, JO, Mullis, LS, Shively, KD, McKinley, TO, Natoli, RM, Sorkin, A, Hill, LC, Hymes, RA, Gaski, GE, Malekzadeh, AS, Ramsey, L, Schulman, JE, Schwartzbach, CC, Sikorski, RA, Lee, OC, Krause, PC, Gary, JL, Achor, TS, Choo, A, Munz, JW, Boutte, SJ, Galpin, MC, Frisch, HM, Kaufman, AM, Lecroy, CM, Smith, CS, Stall, AC, Horne, A, O'Toole, RV, Joshi, M, Nascone, JW, O'Hara, NN, Sciadini, MF, Slobogean, GP, Howe, AL, Hayda, R, Evans, AR, Stawicki, SP, Wojda, TR, Gardner, MJ, Bishop, JA, Rehman, S, Caroom, C, Sheridan, E, Miclau, T, Morshed, S, Higgins, TF, Haller, JM, Spitler, CA, Morandi, MM, Matuszewski, PE, Aneja, A, Bergin, PF, Bhanat, E, Graves, ML, Morellato, J, Teague, D, Ertl, W, Ahn, J, Moloney, GB, Weinlein, JC, Zelle, BA, Agarwal, A, Karia, RA, Sathy, A, Sanders, D, Weiss, DB, Yarboro, SR, Lester-Ballard, V, McVey, ED, Firoozabadi, R, Dagal, A, Kleweno, CP, Agel, J, Whiting, PS, Simske, NM, Siy, AB, Obremskey, WT, Attum, B, Burgos, EJ, Gajari, V, Jahangir, AA, Rodriguez-Buitrago, A, Sethi, M, Stinner, DJ, Tummuru, RR, Trochez, KM, D'Alleyrand, JCG, Allen, LE, Carlini, AR, Collins, SC, Huang, Y & Taylor, TJ 2024, 'Predicting deep infection in pilon and tibial plateau fractures: A secondary analysis of the VANCO and OXYGEN trials', OTA international : the open access journal of orthopaedic trauma, vol. 7, no. 4, e348. https://doi.org/10.1097/OI9.0000000000000348

TY - JOUR

T1 - Predicting deep infection in pilon and tibial plateau fractures

T2 - A secondary analysis of the VANCO and OXYGEN trials

AU - Overmann, Archie L.

AU - Carlini, Anthony R.

AU - O'Toole, Robert V.

AU - Castillo, Renan C.

AU - O'Hara, Nathan N.

AU - Carroll, Eben A.

AU - Goodman, James Brett

AU - Holden, Martha B.

AU - Miller, Anna N.

AU - Spraggs-Hughes, Amanda

AU - Brennan, Michael L.

AU - Tornetta, Paul

AU - Osborn, Patrick M.

AU - Rivera, Jessica C.

AU - Murray, Clinton K.

AU - Kimmel, Joseph E.

AU - Bosse, Michael J.

AU - Hsu, Joseph R.

AU - Karunakar, Madhav A.

AU - Kempton, Laurence B.

AU - Seymour, Rachel B.

AU - Sims, Stephen H.

AU - Churchill, Christine

AU - Sietsema, Debra L.

AU - Gitajn, Ida Leah

AU - Reilly, Rachel M.

AU - Zura, Robert D.

AU - Howes, Cameron

AU - Mir, Hassan

AU - Weaver, Michael J.

AU - Heng, Marilyn

AU - Ly, Thuan V.

AU - Wagstrom, Emily A.

AU - Westberg, Jerald R.

AU - Mullis, Brian H.

AU - Anglen, Jeffrey O.

AU - Mullis, Leilani S.

AU - Shively, Karl D.

AU - McKinley, Todd O.

AU - Natoli, Roman M.

AU - Sorkin, Anthony

AU - Hill, Lauren C.

AU - Hymes, Robert A.

AU - Gaski, Greg E.

AU - Malekzadeh, A. Stephen

AU - Ramsey, Lolita

AU - Schulman, Jeff E.

AU - Schwartzbach, Cary C.

AU - Sikorski, Robert A.

AU - Lee, Olivia C.

AU - Krause, Peter C.

AU - Gary, Joshua L.

AU - Achor, Timothy S.

AU - Choo, Andrew

AU - Munz, John W.

AU - Boutte, Sterling J.

AU - Galpin, Matthew C.

AU - Frisch, H. Michael

AU - Kaufman, Adam M.

AU - Lecroy, C. Michael

AU - Smith, Christopher S.

AU - Stall, Alec C.

AU - Horne, Andrea

AU - O'Toole, Robert V.

AU - Joshi, Manjari

AU - Nascone, Jason W.

AU - O'Hara, Nathan N.

AU - Sciadini, Marcus F.

AU - Slobogean, Gerard P.

AU - Howe, Andrea L.

AU - Hayda, Roman

AU - Evans, Andrew R.

AU - Stawicki, Stanislaw P.

AU - Wojda, Thomas R.

AU - Gardner, Michael J.

AU - Bishop, Julius A.

AU - Rehman, Saqib

AU - Caroom, Cyrus

AU - Sheridan, Elizabeth

AU - Miclau, Theodore

AU - Morshed, Saam

AU - Higgins, Thomas F.

AU - Haller, Justin M.

AU - Spitler, Clay A.

AU - Morandi, Massimo Max

AU - Matuszewski, Paul Edward

AU - Aneja, Arun

AU - Bergin, Patrick F.

AU - Bhanat, Eldrin

AU - Graves, Matt L.

AU - Morellato, John

AU - Teague, David

AU - Ertl, William

AU - Ahn, Jaimo

AU - Moloney, Gele B.

AU - Weinlein, John C.

AU - Zelle, Boris A.

AU - Agarwal, Animesh

AU - Karia, Ravi A.

AU - Sathy, Ashoke

AU - Sanders, Drew

AU - Weiss, David B.

AU - Yarboro, Seth R.

AU - Lester-Ballard, Veronica

AU - McVey, Eric D.

AU - Firoozabadi, Reza

AU - Dagal, Arman

AU - Kleweno, Conor P.

AU - Agel, Julie

AU - Whiting, Paul S.

AU - Simske, Natasha M.

AU - Siy, Alexander B.

AU - Obremskey, William T.

AU - Attum, Basem

AU - Burgos, Eduardo J.

AU - Gajari, Vamshi

AU - Jahangir, A. Alex

AU - Rodriguez-Buitrago, Andres

AU - Sethi, Manish

AU - Stinner, Daniel J.

AU - Tummuru, Rajesh R.

AU - Trochez, Karen M.

AU - D'Alleyrand, Jean Claude G.

AU - Allen, Lauren E.

AU - Carlini, Anthony R.

AU - Collins, Susan C.

AU - Huang, Yanjie

AU - Taylor, Tara J.

PY - 2024/11/25

Y1 - 2024/11/25

N2 - Objectives:To develop and validate a prediction model for a deep surgical site infection (SSI) after fixation of a tibial plateau or pilon fracture.Design:Pooled data from 2 randomized trials (VANCO and OXYGEN).Setting:Fifty-two US trauma centers.Patients:In total, 1847 adult patients with operatively treated tibial plateau or pilon fractures who met criteria for a high risk of infection.Intervention:We considered 13 baseline patient characteristics and developed and externally validated prediction models using 3 approaches (logistic regression, stepwise elimination, and machine learning).Main Outcomes and Measures:The primary prediction model outcome was a deep SSI requiring operative debridement within 182 days of definitive fixation. Our primary prognostic performance metric for evaluating the models was area under the receiver operating characteristic curve (AUC) with clinical utility set at 0.7.Results:Deep SSI occurred in 75 VANCO patients (8%) and in 56 OXYGEN patients (6%). The machine learning model for VANCO (AUC = 0.65) and stepwise elimination model for OXYGEN (AUC = 0.62) had the highest internal validation AUCs. However, none of the external validation AUCs exceeded 0.64 (range, 0.58 to 0.64).Conclusions:The predictive models did not reach the prespecified clinical utility threshold. Our models' inability to distinguish high-risk from low-risk patients is likely due to strict eligibility criteria and, therefore, homogeneous patient populations.

AB - Objectives:To develop and validate a prediction model for a deep surgical site infection (SSI) after fixation of a tibial plateau or pilon fracture.Design:Pooled data from 2 randomized trials (VANCO and OXYGEN).Setting:Fifty-two US trauma centers.Patients:In total, 1847 adult patients with operatively treated tibial plateau or pilon fractures who met criteria for a high risk of infection.Intervention:We considered 13 baseline patient characteristics and developed and externally validated prediction models using 3 approaches (logistic regression, stepwise elimination, and machine learning).Main Outcomes and Measures:The primary prediction model outcome was a deep SSI requiring operative debridement within 182 days of definitive fixation. Our primary prognostic performance metric for evaluating the models was area under the receiver operating characteristic curve (AUC) with clinical utility set at 0.7.Results:Deep SSI occurred in 75 VANCO patients (8%) and in 56 OXYGEN patients (6%). The machine learning model for VANCO (AUC = 0.65) and stepwise elimination model for OXYGEN (AUC = 0.62) had the highest internal validation AUCs. However, none of the external validation AUCs exceeded 0.64 (range, 0.58 to 0.64).Conclusions:The predictive models did not reach the prespecified clinical utility threshold. Our models' inability to distinguish high-risk from low-risk patients is likely due to strict eligibility criteria and, therefore, homogeneous patient populations.

KW - fracture related infection

KW - infection

KW - machine learning

KW - pilon fracture

KW - prediction model

KW - surgical site infection

KW - tibial plateau fracture

UR - http://www.scopus.com/inward/record.url?scp=85210949775&partnerID=8YFLogxK

U2 - 10.1097/OI9.0000000000000348

DO - 10.1097/OI9.0000000000000348

M3 - Article

AN - SCOPUS:85210949775

SN - 2574-2167

VL - 7

JO - OTA international : the open access journal of orthopaedic trauma

JF - OTA international : the open access journal of orthopaedic trauma

IS - 4

M1 - e348

ER -