Discussion
pilon fractures, fracture, infection, SSI, pilon fracture, injuries, diabetes
INFECTION, DIABETES
Ruedi and Allgower first published their surgical technique and early follow-up results for the treatment of pilon fractures in 1968, a key shift in treatment [In our research, 71 (18.35%) patients in the training group developed SSI and 23 (17.83%) patients in the validation group developed SSI. Previous studies have shown similar deep infection rates [The relationship between diabetes and SSI in pilon fractures remains unclear. Some articles reported that diabetes was not associated with deep infection in pilon fractures [Operating time is a well-established risk factor for SSI and may be a marker of technical difficulties, more extensive soft tissue dissection, and prolonged wound exposure, all of which contribute to an increased incidence of SSI. Our results demonstrated that patients with prolonged operative time were more likely to develop SSI. Ren et al. believed that operative time longer than 150 min was associated with an increased risk of SSI following surgical fixation of pilon fractures [Previous studies have shown that open fracture was associated with deep infection after pilon fractures, but there are few reports of closed soft tissue injuries associated with infection [To our knowledge, our article was the first study on risk factors and predictive model for SSI in closed pilon fracture patients. However, our work had some limitations. First, this study was a single-center retrospective study, and the sample size of the selected cases was relatively small. Second, the baseline characteristic data were not truly homogenous and there was bias. Third, for the validation of the predictive model we used internal data, not external data.