Early versus delayed surgical treatment of open tibial fractures: effect on the rates of infection and need of secondary surgical procedures to promote bone union

Charalambous, Constadina; Siddique, Irfan; Zenios, M.; Roberts, Stephen A; Samarji, Richard; Paul, A. J.; Hirst, P.

doi:10.1016/j.injury.2004.10.007

Cited by 81 publications

(44 citation statements)

References 12 publications

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“…Numerous studies [1][2][3][4][5][6][7][8][9] have questioned the association between delayed surgical treatment and the development of deep infection in open long bone fractures. Schenker et al, 10 in a recent meta-analyses of 3539 open fractures, reported similar findings.…”

Section: Introductionmentioning

confidence: 99%

Time to Initial Operative Treatment Following Open Fracture Does Not Impact Development of Deep Infection

Weber

Dulai

Bergman

et al. 2014

Journal of Orthopaedic Trauma

103

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Section: Introductionmentioning

confidence: 99%

Time to Initial Operative Treatment Following Open Fracture Does Not Impact Development of Deep Infection

Weber

Dulai

Bergman

et al. 2014

Journal of Orthopaedic Trauma

103

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“…All six studies [6,15,16,29,35,45] with data regarding flap rates and extended negative pressure wound therapy use reported a decrease in flap procedures with extended negative pressure wound therapy. Two [15,16] of the studies reported infection complications similar to those of historic controls [1,11,13,20,26,28]. Dedmond et al [15,16] concluded the avoidance of flap procedures, particularly in the pediatric population, in the end outweighed the equivalent infection rates.…”

Section: Does Negative Pressure Wound Therapy Facilitate Late Flap Prmentioning

confidence: 94%

“…The question was whether use of negative pressure wound therapy beyond 72 hours would result in increased infection rates compared with historic controls [1,11,13,20,26,28]. Reported infection rates are highly variable for Grade IIIB tibia wounds with the upper end at 67% [10].…”

Section: Does Negative Pressure Wound Therapy Facilitate Late Flap Prmentioning

confidence: 99%

Negative Pressure Wound Therapy in Grade IIIB Tibial Fractures: Fewer Infections and Fewer Flap Procedures?

Schlatterer

Hirschfeld

Webb

2015

Clinical Orthopaedics &Amp; Related Research

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Background Grade IIIB open tibia fractures are devastating injuries. Some clinicians advocate wound closure or stable muscle flap coverage within 72 hours to limit complications such as infection. Negative pressure wound therapy was approved by the FDA in 1997 and has become an adjunct for many surgeons in treating these fractures. Opinions vary regarding the extent to which negative pressure wound therapy contributes to limb salvage. Evidence-based practice guidelines are limited for use of negative pressure wound therapy in Grade IIIB tibia fractures. This systematic literature review of negative pressure wound therapy in Grade IIIB tibia fractures may substantiate current use and guide future studies. Questions/purposes We sought to answer the following:(1) Does the use of negative pressure would therapy compared with gauze dressings lead to fewer infections? (2) Does it allow flap procedures to be performed safely beyond 72 hours without increased infection rates? (3) Is it associated with fewer local or free flap procedures? Methods We conducted a systematic review of six large databases (through September 1, 2013) for studies reporting use of negative pressure wound therapy in Grade IIIB open tibia fractures, including information regarding infection rates and soft tissue reconstruction. The systematic review identified one randomized controlled trial and 12 retrospective studies: four studies compared infection rates between negative pressure wound therapy and gauze dressings, 10 addressed infection rates with extended use, and six reported on flap coverage rates in relation to negative pressure wound therapy use beyond 72 hours. None of the 13 studies was eliminated owing to lack of study quality.

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“…Tibial shaft fractures which are defined as ones occuring 4 cm distal to the tibial tuberosity to 4 cm proximal to the ankle are treated with interlocking techniques [2] . The results of this technique have given excellent for treating fractures of the tibial shaft [3][4][5][6] . This involves the insertion of a metal rod, usually from the upper side of the tibia, into the inner cavity (medulla) of the tibia.…”

Section: Introductionmentioning

confidence: 99%

Outcome analysis of interlocking nailing for tibial shaft fractures

Babu¹,

Muthu²,

Sukumar³

2018

Int. J. Orthop. Sci.

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The results of closed intramedullary nailing technique are excellent for treating fractures of the tibial shaft. We decided to analyse the outcome of primary interlocking nailing done for tibial fractures. All patients with tibial shaft fractures treated with primary interlocking nail were evaluated. Static or dynamic locking was done depending upon the fracture pattern and stability. 44 fractures were included in the study. Reaming was done in 41 (93%) patients rest of them being unreamed nailing for compound fractures. Nine (20%) of the nails were dynamically locked. 95.6% united uneventfully except two (4.4%). The average time to union was 26 weeks. Primary Interlocking nailing for tibial shaft fractures is an excellent method of definite surgical management of closed and compound fractures of tibia. Interlocking nailing has less chance of complications like infection and non union as expected in compound injuries with bone loss. It is more acceptable to patients than external fixators in these scenarios.

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Early versus delayed surgical treatment of open tibial fractures: effect on the rates of infection and need of secondary surgical procedures to promote bone union

Cited by 81 publications

References 12 publications

Time to Initial Operative Treatment Following Open Fracture Does Not Impact Development of Deep Infection

Time to Initial Operative Treatment Following Open Fracture Does Not Impact Development of Deep Infection

Negative Pressure Wound Therapy in Grade IIIB Tibial Fractures: Fewer Infections and Fewer Flap Procedures?

Outcome analysis of interlocking nailing for tibial shaft fractures

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