Literature DB >> 14608171

Outcomes in open tibia fractures: relationship between delay in treatment and infection.

Monti Khatod1, Michael J Botte, David B Hoyt, R Scott Meyer, Jeffrey M Smith, Wayne H Akeson.   

Abstract

BACKGROUND: Emergent irrigation and debridement has been accepted as a mainstay of open fracture treatment. The purpose of this study was to evaluate the infectious outcome of open tibia fractures relative to the time from injury to operative irrigation and debridement.
METHODS: One hundred seventy-eight patients with 191 consecutive fractures were retrospectively reviewed. Of these, 103 patients with 106 fractures were available for this study, with an average follow-up of 10.23 months.
RESULTS: Results revealed 21.7% type I fractures, 43.4% type II fractures, 16.0% type IIIa fractures, 11.3% type IIIb fractures, and 7.5% type IIIc fractures. Of all fracture types, 22.6% became infected and 5.7% went on to have osteomyelitis. The average time to treatment was not significantly different in infected versus noninfected fractures across fracture types. No infection occurred when the time to surgery was within 2 hours; however, no significant increase in infection was discovered with respect to patients treated after 6 hours compared with those treated within 6 hours.
CONCLUSION: The results support the Gustilo grading system of open fractures as a significant prognostic indicator for infectious complication. We continue to support the emergent treatment of open tibia fractures.

Entities:  

Mesh:

Year:  2003        PMID: 14608171     DOI: 10.1097/01.TA.0000092685.80435.63

Source DB:  PubMed          Journal:  J Trauma        ISSN: 0022-5282


  35 in total

Review 1.  [Prevention of infection in the current treatment of open fractures: an evidence-based systematic analysis].

Authors:  S Grote; H Polzer; W C Prall; S Gill; S Shafizadeh; M Banerjee; B Bouillon; H Bäthis
Journal:  Orthopade       Date:  2012-01       Impact factor: 1.087

2.  Early or delayed surgical treatment in compound limb fractures due to high velocity missile injuries: a 5-year retrospective study from Medical City in Baghdad.

Authors:  Ali Bakir Al-Hilli; Dheyaa Saeed Salih
Journal:  Iowa Orthop J       Date:  2010

Review 3.  The role of intramedullary nailing in treatment of open fractures.

Authors:  A Hofmann; S-O Dietz; P Pairon; P M Rommens
Journal:  Eur J Trauma Emerg Surg       Date:  2014-12-24       Impact factor: 3.693

Review 4.  Timing of Debridement and Infection Rates in Open Fractures of the Hand: A Systematic Review.

Authors:  Constantinos Ketonis; Joseph Dwyer; Asif M Ilyas
Journal:  Hand (N Y)       Date:  2016-07-08

5.  Impact of negative pressure wound therapy on open diaphyseal tibial fractures: A prospective randomized trial.

Authors:  Siddharth R Virani; Aditya A Dahapute; S S Bava; Saurabh R Muni
Journal:  J Clin Orthop Trauma       Date:  2016-07-16

6.  Evaluation of the orthopaedic trauma association open fracture classification (OTA-OFC) as an outcome prediction tool in open tibial shaft fractures.

Authors:  Matthew R Garner; Stephen J Warner; Jacob A Heiner; Yesul T Kim; Julie Agel
Journal:  Arch Orthop Trauma Surg       Date:  2021-05-16       Impact factor: 3.067

Review 7.  Timing issue in open fractures debridement: a review article.

Authors:  Alberto Jorge-Mora; Juan Rodriguez-Martin; Juan Pretell-Mazzini
Journal:  Eur J Orthop Surg Traumatol       Date:  2012-04-04

8.  No Disparity for American Indians in Surgery for Pelvis/Lower Extremity Fractures: a Cohort Study of the National Trauma Data Bank (NTDB).

Authors:  Alan Cook; Kristina Chapple; Neil Motzkin; Jeanette Ward; Forrest Moore
Journal:  J Racial Ethn Health Disparities       Date:  2016-08-23

9.  The Gustilo-Anderson classification system as predictor of nonunion and infection in open tibia fractures.

Authors:  R V Thakore; E L Francois; S K Nwosu; B Attum; P S Whiting; M A Siuta; M A Benvenuti; A K Smith; M S Shen; I Mousavi; W T Obremskey; M K Sethi
Journal:  Eur J Trauma Emerg Surg       Date:  2016-09-22       Impact factor: 3.693

10.  Treatment principles in the management of open fractures.

Authors:  William W Cross; Marc F Swiontkowski
Journal:  Indian J Orthop       Date:  2008-10       Impact factor: 1.251

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