Open leg fractures carry a substantial risk of surgical-site

infection (SSI). Trauma-related stress hyperglycemia may impair

innate immunity even in patients without diabetes, but its value

at the time of emergency admission is not well defined in this

specific orthopaedic population.

In nondiabetic patients with open leg fractures, higher

admission glucose was associated with SSI within 1 year

and remained significant in the multivariable model.

SSI was also associated with substantially longer hospitalization

and a longer interval to definitive fixation.

CLINICAL MESSAGE: admission glucose may help flag higher-

risk patients early in the orthopaedic trauma pathway.