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Reynolds AW, Garay M, Philp FH, et al. Definitive fixation of open tibia fractures: Does reopening the traumatic wound increase complication rates?. J Clin Orthop Trauma. 2021;24:101715doi: 10.1016/j.jcot.2021.101715.
Reynolds, A. W., Garay, M., Philp, F. H., Hammarstedt, J. E., Altman, G. T., & Nwankwo, C. D. (2022). Definitive fixation of open tibia fractures: Does reopening the traumatic wound increase complication rates?. Journal of clinical orthopaedics and trauma, 24101715. https://doi.org/10.1016/j.jcot.2021.101715
Reynolds, Alan W, et al. "Definitive fixation of open tibia fractures: Does reopening the traumatic wound increase complication rates?." Journal of clinical orthopaedics and trauma vol. 24 (2022): 101715. doi: https://doi.org/10.1016/j.jcot.2021.101715
Reynolds AW, Garay M, Philp FH, Hammarstedt JE, Altman GT, Nwankwo CD. Definitive fixation of open tibia fractures: Does reopening the traumatic wound increase complication rates?. J Clin Orthop Trauma. 2021 Nov 27;24:101715. doi: 10.1016/j.jcot.2021.101715. eCollection 2022 Jan. PMID: 34926147; PMCID: PMC8649794.
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J Clin Orthop Trauma. 2021 Nov 27;24:101715. doi: 10.1016/j.jcot.2021.101715. eCollection 2022 Jan.

Definitive fixation of open tibia fractures: Does reopening the traumatic wound increase complication rates?.

Journal of clinical orthopaedics and trauma

Alan W Reynolds, Mariano Garay, Frances Hite Philp, Jon E Hammarstedt, Gregory T Altman, Chima D Nwankwo

Affiliations

  1. Department of Orthopaedic Surgery, Allegheny General Hospital, Allegheny Health Network, Pittsburgh, PA, USA.
  2. Division of Orthopaedic Surgery, NewYork-Presbyterian Brooklyn Methodist Hospital, Brooklyn, NY, USA.

PMID: 34926147 PMCID: PMC8649794 DOI: 10.1016/j.jcot.2021.101715

Abstract

BACKGROUND: It is unknown if surgical approach or use of previous traumatic wounds for open fracture instrumentation has an impact on patient complications or outcomes. This study sought to compare infection and nonunion rates in the staged treatment of open tibia fractures where the traumatic wound was reopened during definitive fixation versus when they were not.

METHODS: A retrospective review was performed on all patients at a single institution level 1 trauma center. All patients who had a minimum of 1 year clinical and radiographic outcomes were included. Primary outcome measures were incidence of infection and nonunion. Groups of patients were compared based on surgical approach for definitive fixation.

RESULTS: A total of 96 patients were included - 48 patients received definitive treatment and wound closure during initial management of the open fracture (group 1), 22 patients had staged fixation through new incisions (group 2), and 26 patients had their traumatic wound reopened during definitive fixation (group 3). Rates of infection were 10.4%, 31.8% and 11.5% respectively (p = 0.15). Rates of nonunion were 20.8%, 27.3% and 30.8% (p = 1.0). No statistically significant differences in regards to primary outcomes were found between the staged fixation groups. Multiple logistic regression also showed no difference in infection or nonunion when controlling for known risk factors.

CONCLUSION: For open tibia fractures that underwent staged fixation, no significant differences in infection or nonunion were observed between procedures that involved reopening the traumatic wound versus procedures performed through new incisions. The presence of a distal tibia periarticular fracture was found to be independently associated with infection risk.

© 2021 Delhi Orthopedic Association. All rights reserved.

Keywords: Delayed fixation; Infection; Open fracture; Tibia

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