Abstract: OBJECTIVE To explore the risk factors for postoperative pulmonary infections in the patients with traumatic fracture and observe the distribution of pathogens. METHODS A total of 1023 patients with traumatic fracture who received surgical procedures in Zhucheng People's Hospital Affiliated to Shandong Second Medical University from Jan. 2022 to Dec. 2024 were enrolled in the study and were divided into the infection group with 127 cases and the non-infection group with 896 cases according to the status of postoperative pulmonary infections. The independent risk factors that induced the postoperative pulmonary infections were screened out and analyzed by using multivariate logistic regression model. RESULTS The incidence rate of postoperative pulmonary infections was 12.41%(127/1023). The etiological analysis showed that totally 116 strains of pathogens were isolated from the 127 patients with the infections, of which 75.86% were gram-negative bacteria, 24.14% were gram-positive bacteria. The top 5 species of pathogens were successively as follows: Klebsiella pneumoniae(22.41%), Escherichia coli (20.69%), Pseudomonas aeruginosa (13.79%), Staphylococcus aureus (11.21%), Acinetobacter baumannii(7.76%). Among the 116 strains of pathogens, there were 20 (17.24%) strains of multidrug-resistant organisms. Multivariate analysis indicated that the no less than 65 years of age, smoking history, complication with diabetes mellitus, high injury severity score (ISS), long operation duration and long postoperative bedridden time were proved as the risk factors for the postoperative pulmonary infections in the patients with traumatic fracture(P＜0.05). CONCLUSIONS The age, smoking history, diabetes mellitus, ISS score, operation duration, postoperative bedridden time are the influencing factors for the postoperative pulmonary infections in the patients with traumatic fractures. The gram-negative bacteria are dominant among the pathogens. It is necessary to take targeted prevention and control measures so as to reduce the incidence of the infections.