2024 AAOS Annual Meeting: Are drains associated with infection after operative fixation of high-risk tibial plateau and pilon fractures?

978 patients with a high-risk tibial plateau or pilon fracture were included in this randomized controlled trial substudy. Patients were randomized based on the use of a drain and vancomycin powder. The primary outcome of interest was deep surgical site infection within 6 months. There was no significant association between deep infection rates with and without drain use. A strong association was observed with the highest deep infection rate of 13% occurring when vancomycin powder was not used with drains. The lowest infection rate was observed in patients treated with both vancomycin powder and drains.