Objectives: To investigate and compare the predictive ability of the Orthopaedic Trauma Association-Open Fracture Classification (OTA-OFC) and the Gustilo-Anderson classification systems for fracture-related infections (FRI) in patients with open tibia fractures.
Design: Retrospective cohort study.
Setting: Academic trauma center.
Patient Selection Criteria: Patients aged 16 years or older with an operatively treated open tibia fracture (OTA-AO 41, 42, and 43) between 2010 and 2021.
Outcome Measures And Comparisons: The primary outcome was FRI. The OTA-OFC and the Gustilo-Anderson classifications were compared in their ability to predict FRI.
Results: Eight hundred ninety patients (mean age, 43 years [range, 17 to 96]; 75% men) with 912 open tibia fractures were included. In total, 142 (16%) had an infection. The OTA-OFC was not significantly better at predicting FRI than the Gustilo-Anderson classification (area under the curve, 0.66 vs. 0.66; P = 0.89). The Gustilo-Anderson classification was a stronger predictor of FRI than any single OTA-OFC domain, explaining 72% of FRI variance. Only the addition of the OTA-OFC wound contamination domain to Gustilo-Anderson significantly increased the variance explained (72% vs. 84%, P = 0.04). Embedded contamination increased the risk of FRI by approximately 10% as the risk of FRI with embedded contamination was 16% for type I or type IIs, 26% for type IIIAs, 45% for type IIIBs, and 46% for type IIICs.
Conclusions: The more complex OTA-OFC system was not better than the Gustilo-Anderson classification system in predicting FRIs in patients with open tibia fractures. Adding embedded wound contamination to the Gustilo-Anderson classification system significantly improved its prognostic ability.
Level Of Evidence: Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1097/BOT.0000000000002907 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Limb Salvage Versus Amputation: A Review of Variables Influencing the Assessment and Decision-Making in Complex Limb Fracture Management.
Cureus
November 2024
Emergency Medicine, West Midlands Deanery, Birmingham, GBR.
Complex limb injuries are combination injuries that involve all components of a limb's tissue, such as skin, bone with its surrounding soft tissue cover, and neurovascular elements. Complex limb trauma often has a background of a significant mechanism of injuries such as high-velocity road traffic accidents, ballistic injuries, industrial accidents, and other major mechanisms of injuries which involve high amounts of energy transfer through these tissue layers. These injuries pose a major challenge to trauma and orthopaedic surgeons.
View Article and Find Full Text PDFA Prospective Study on the Suprapatellar Approach for Tibial Shaft Fractures: Insights Into Functional and Radiological Outcomes.
Cureus
November 2024
Orthopedics and Traumatology, KIMS - Saveera Hospital, Anantapur, IND.
Background: Tibial shaft fractures are among the most common long bone injuries and often can be challenging to manage surgically. While infrapatellar (IP) intramedullary nailing (IMN) has been a widely accepted treatment, its limitations have led to the emergence of alternative approaches, such as suprapatellar nailing (SPN) in a semi-extended knee position.
Aim: To evaluate the clinical, radiological, and functional outcomes of tibial shaft fractures treated with an SPN approach in a semi-extended knee position.
A Scoping Review on the Management of Open Fractures in African Trauma and Orthopaedics Centres.
Cureus
September 2024
Trauma and Orthopaedics, Surgery Interest Group of Africa, Lagos, NGA.
Article Synopsis
- - An open fracture is characterized by the bone being exposed through the skin due to injury, often resulting from high-energy incidents like road traffic accidents, which are the main cause in Africa.
- - A review of 39 studies indicated that the Tibia is the most commonly affected bone, with significant issues including malunion, non-union, and wound infections after treatment.
- - The study highlights the importance of having standardized treatment protocols and better emergency services to handle open fractures effectively across Africa.
Functional Outcome of Solid Interlocking Nail in Open Tibial Fracture at a Tertiary Care Center: A Descriptive Cross-sectional Study.
JNMA J Nepal Med Assoc
April 2024
Nepal Medical College and Teaching Hospital, Jorpati, Kathmandu, Nepal.
Introduction: There is a high incidence of open fractures accounting 23% of all tibial fractures. The minimal soft tissue and precarious blood supply of the shaft of tibia make these fractures vulnerable to complications. The treatment should be decided through thoughtful analysis for personality of injuries and the status of the soft tissue.
View Article and Find Full Text PDFComparison of Early Versus Late Debridement Outcomes in the Management of Open Distal Radius Fractures.
J Hand Surg Am
September 2024
Rothman Orthopaedic Institute, Philadelphia, PA. Electronic address:
Purpose: The optimal timing for surgical treatment of open distal radius fractures remains an area of debate. The purpose of this study was to examine the outcomes of open distal radius fractures treated surgically before or after 24 hours.
Methods: A multicenter retrospective review was performed on all open distal radius fractures treated over 11 years.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!