title: An observational case series of HIV-positive patients treated with open reduction internal fixation for a closed lower extremity fracture.
abstract: OBJECTIVE
  The purpose of this study was to investigate the influence of immune deficiency status of HIV-positive patients on postoperative complication such as surgical site infection and nonunions.
  
  
  METHODS
  Retrospective observational cohort study: Level III.
  
  
  METHODS
  Level I trauma center.
  
  
  METHODS
  Consecutive adult HIV-positive patients with closed fractures who underwent operative treatment between January 1, 2001 and December 31, 2012.
  
  
  METHODS
  postoperative complication including infection and fracture nonunion.
  
  
  RESULTS
  A total of 42 HIV-positive patients with closed fractures who underwent surgical fracture fixation were identified during the 12-year study time window. Of these, 18 patients were excluded due to incomplete medical records (n = 16) or open fractures (n = 2). The remaining 24 patients with closed fracture treated surgically (19 males and 5 females; mean age 45.1 ± 10.5 years; age range 20-67 years) were included in the study. Within a 6-month period from the time of injury, 16 patients had a CD4+ cell count >200 and five patients had a CD4+ cell count <200 (CD4+ cell count was not available in three patients). Twenty-two patients (91.6 %) were on antiretroviral therapy at the time of injury. Only one patient, with associated end-stage renal failure and diabetes mellitus, developed a postoperative infection (4.2 %). All patients achieved fracture union within 180 days postoperatively, without the need for surgical revisions.
  
  
  CONCLUSIONS
  Our study suggests that HIV infection does not seem to correlate with a higher risk for the development of postoperative complication related to surgical site infection and fracture nonunions after operative fixation of closed fractures.
authors: Department of Orthopaedics, Denver Health Medical Center, School of Medicine, University of Colorado, 777 Bannock Street, Denver, CO, 80204, USA.
authors: Jiandong
authors: J
authors: Hao
authors: Benoit
authors: B
authors: Herbert
authors: Juan C
authors: JC
authors: Quispe
authors: Derly O
authors: DO
authors: Cuellar
authors: Vivek
authors: V
authors: Chadayammuri
authors: Ji Wan
authors: JW
authors: Kim
authors: Heather
authors: H
authors: Young
authors: Mark E
authors: ME
authors: Hake
authors: Mark E
authors: ME
authors: Hammerberg
authors: David J
authors: DJ
authors: Hak
authors: Cyril
authors: C
authors: Mauffrey
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D005593:Fracture Fixation, Internal / Q000009:adverse effects / Q000379:methods*; D005596:Fractures, Closed / Q000150:complications / Q000601:surgery*; D006679:HIV Seropositivity / Q000150:complications; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology; D012189:Retrospective Studies; D012307:Risk Factors; D013530:Surgical Wound Infection / Q000209:etiology; D055815:Young Adult
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