The incidence of osteitis in open fractures: an analysis of 948 open fractures (a review of the Hannover experience).

Even though treatment protocols of open fractures have been improved in the past two decades, osteitis is still a major complication in these injuries. To investigate the primary factors responsible for posttraumatic osteitis, 19 cases of osteitis out of 297 open fractures (retrospective series from 1981 to 1983) and nine cases of osteitis out of 651 open fractures (prospective series from 1984 to 1989) were analyzed. The Hannover fracture scale was used for quantitative evaluation of the injury. A high prognostic index for bone infections was found for the amount of bone loss, the fracture type, the type of bacteriologic contamination, deep soft-tissue defects, compartment syndromes, vascular injuries, and soft-tissue infections.