Complications of Open Tibial Fracture Management: Risk Factors and Treatment
- Author:
Lua JYC
;
Tan VH
;
Sivasubramanian H
;
Kwek EBK
- Publication Type:Journal Article
- Keywords:
open tibial fractures;
infection;
complications;
antimicrobial
- MeSH:
Tibial Fractures
- From:Malaysian Orthopaedic Journal
2017;11(1):18-22
- CountryMalaysia
- Language:English
-
Abstract:
Open tibial fractures result in high rates of complications.
This study aims to elucidate the risk factors causing these
complications, and suggest antimicrobial regimens based on
the organisms grown in post-operative infections. Over a
period of five years, 173 patients had sustained open tibial
fractures and undergone operative treatment at a single
institution. All surgical data was gathered retrospectively
through online medical records. Thirty-one patients (17.9%)
had sustained post-operative bony complications, while
infective complications were reported in 37 patients (21.4%).
Patients with Gustilo type III fractures were found to be
more than three times as likely to sustain post-operative
infective (p=0.007) or bony (p=0.015) complications,
compared to Gustilo type I or II fractures. The fracture
location and time taken to fixation did not significantly affect
the complication rate, but results were trending towards
significance. The commonest cause of infective
complications were hospital-acquired organisms, such as
Methicillin-resistant staphylococcus aureus (40.5%). Closer
monitoring of patients sustaining high grade Gustilo open
fractures, as well as antimicrobial prophylaxis for both
hospital-acquired organisms and environmental
contaminants, will result in the best outcome for patients.
Further studies with larger sample sizes are warranted, to
determine the significance of fracture location and time
taken to fixation on complication rates.
- Full text:P020170413471563535418.pdf
