Supplemental Perioperative Oxygen to Reduce Surgical Site Infection After High Energy Fracture Surgery

Inclusion Criteria: * All "high energy" tibial plateau fractures treated operatively with plate and screw fixation. We define "high energy" tibial plateau fractures as patients who are either: * Initially treated with an external fixation and treated more than 7 days later after swelling has resolved. * Gustilo Type I, II, and IIIA open fracture, regardless of timing of definitive treatment. * All "high energy" pilon (distal tibial plafond) fractures treated operatively with plate and screw fixation. We define "high energy" tibial plateau fractures as patients who are either: * Initially treated with an external fixation (with or without fibula fixation or limited internal fixation) and treated definitively more than 7 days later after swelling has resolved. * Gustilo Type I, II, and IIIA open fracture, regardless of timing of definitive treatment. * All "high energy" calcaneus fractures treated operatively with plate and screw fixation in a staged fashion. We define "high energy" calcaneus fractures as patients who are either: * Treated definitively more than 7 days later after swelling has resolved. * Gustilo Type Type I, II, and IIIA \[30,31\] open fracture, regardless of timing of definitive treatment. * Ages 18 to 80 years * Patients may have co-existing infection not at study fracture site, with or without antibiotic treatment. * Patients may have risk factors for infection including diabetes, immunosuppression from steroids or other medications, HIV, or…