A pilot prospective study of forward-looking infrared (FLIR) camera measurements to predict postoperative wound complications in high-energy lower extremity fractures

Eur J Orthop Surg Traumatol. 2024 Nov 21;35(1):16. doi: 10.1007/s00590-024-04117-z.

Abstract

Purpose: To prospectively determine if forward-looking infrared (FLIR) camera temperature measurements can predict postoperative wound complications in high-energy lower extremity fractures.

Methods: This is a prospective cohort study from a single level 1 trauma centre. Adult patients who sustained unilateral high-energy lower extremity fractures (tibial plateau, tibial plafond, trimalleolar ankle, midfoot, or calcaneus fractures) were included in the study. Preoperative and post-induction FLIR thermographic measurements were taken using the FLIRONE ® PRO camera system. The main outcome of interest was the development of any wound related postoperative complication.

Results: Forty-eight patients were included in the study. A majority of the patients were male (58%) with a mean age of 44.2 years. FLIR imaging detected temperature differences between the operative extremity and the contralateral extremity, both in the preoperative area and following induction (Pre-op: 33.0 vs 30.8, p < 0.001; Post-induction: 29.6 vs 28.5, p = 0.046). Overall, 11 (23.9%) patients experienced a wound complication. Regression analysis did not demonstrate a significant association between preoperative or post-induction FLIR measurements and the development of wound complications.

Conclusion: While FLIR imaging could detect temperature changes related to traumatic injury, these differences did not correlate with postoperative outcomes. Further large-scale study may be warranted.

Level of evidence: III.

Keywords: Forward-looking infrared camera; Orthopaedic trauma; Wound complications.

MeSH terms

  • Adult
  • Aged
  • Female
  • Fractures, Bone / diagnostic imaging
  • Fractures, Bone / surgery
  • Humans
  • Infrared Rays
  • Male
  • Middle Aged
  • Pilot Projects
  • Postoperative Complications / diagnosis
  • Postoperative Complications / etiology
  • Predictive Value of Tests
  • Prospective Studies
  • Surgical Wound Infection / diagnosis
  • Surgical Wound Infection / etiology
  • Thermography* / methods
  • Tibial Fractures / diagnostic imaging
  • Tibial Fractures / surgery