The Effect of Time to Definitive Treatment on the Rate of Nonunion and Infection in Open Fractures

Harley, Brian J.; Beaupré, Lauren A; Jones, Clifford; Dulai, Sukhdeep; Weber, Donald

doi:10.1097/00005131-200208000-00006

Cited by 226 publications

(140 citation statements)

References 17 publications

Supporting

Mentioning

121

Contrasting

Unclassified

Order By: Relevance

“…In a recent study our group demonstrated a significant increase in the TGF-β1 concentration in fracture haematoma and in serum of patients with long bone fracture. These results indicated the importance of this cytokine for fracture healing and confirmed other clinical and experimental studies [8][9][10][11][12][13][14][15][16][17]. Circulating TGF-β1 levels were found to be a predictor of delayed bone healing and non-union [11].…”

Section: Introductionsupporting

confidence: 85%

See 1 more Smart Citation

Is the expression of Transforming Growth Factor-Beta1 after fracture of long bones solely influenced by the healing process?

Kaiser

Thomas

Köttstorfer

et al. 2012

International Orthopaedics (SICOT)

View full text Add to dashboard Cite

Purpose Circulating TGF-β1 levels were found to be a predictor of delayed bone healing and non-union. We therefore aimed to investigate some factors that can influence the expression of TGF-β1. The correlation between the expression of TGF-β1 and the different socio-demographic parameters was analysed. Methods Fifty-one patients with long bone fractures were included in the study and divided into different groups according to their age, gender, cigarette smoking status, diabetes mellitus and regular alcohol intake. TGF-β1 levels were analysed in patient's serum and different groups were retrospectively compared. Results Significantly lower TFG-β1 serum concentrations were observed in non-smokers compared to smokers at week 8 after surgery. Significantly higher concentrations were found in male patients compared to females at week 24. Younger patients had significantly higher concentrations at week 24 after surgery compared to older patients. Concentrations were significantly higher in patients without diabetes compared to those with diabetes at six weeks after surgery. Patients with chronic alcohol abuse had significantly higher concentrations compared to those patients without chronic alcohol abuse. Conclusion TGF-β1 serum concentrations vary depending upon smoking status, age, gender, diabetes mellitus and chronic alcohol abuse at different times and therefore do not seem to be a reliable predictive marker as a single-pointin-time measurement for fracture healing.

show abstract

Section: Introductionsupporting

confidence: 85%

“…Evidence exists that the local and systemic concentrations of different osteogenic growth factors are increased during fracture healing [8][9][10][11][12][13][14][15][16][17]. Among these factors TGF-β1 is known to be pivotal for the bone healing.…”

Section: Introductionmentioning

confidence: 99%

Is the expression of Transforming Growth Factor-Beta1 after fracture of long bones solely influenced by the healing process?

Kaiser

Thomas

Köttstorfer

et al. 2012

International Orthopaedics (SICOT)

View full text Add to dashboard Cite

show abstract

“…8 The management of open fractures is regarded as an orthopaedic emergency. 9 The traditional method of treating open tibial fractures was with an external fixator preferably within six hours of injury. 10,11 Monolateral external fixation has been employed to treat open tibial fractures with great success; however, not without significant complications.…”

Section: Introductionmentioning

confidence: 99%

Outcomes of intramedullary nailing for open fractures of the tibial shaft

Seron¹,

Rasool

2018

SA orthop. j.

View full text Add to dashboard Cite

Aim: To establish superficial and deep infection rates and time to union of open tibial shaft fractures treated with primary debridement and locked intramedullary nails. Materials and methods:The clinical records and radiographs were retrospectively reviewed of 74 Gustilo-Anderson grades 1 to 3A open tibial shaft fractures that were treated by initial debridement and intramedullary nail fixation over a two-year period. Sixty-three men and nine women with a mean age of 33 years (range 16-67) were followed up for a mean period of 18 months (range 7-32).Results: Sixteen patients (22%) sustained grade 1 injuries, 38 (51%) grade 2, and 20 (27%) had grade 3A injuries. Thirteen patients (18.1%) were HIV positive. The mean time to surgery was 28 hours (range 8-112). The overall infection rate was 17.6%. Superficial infection developed in 10.8% and deep infection occurred in 6.8%. There was no association between time to surgery and infection rate (p=0.878). There was no association between HIV status and infection (p=0.471). There was no association between type of closure and sepsis (p=0.410). The mean time to union was 17 weeks (range 12-50). Five patients (6.9%) had delayed union and one patient failed to unite without undergoing secondary procedures. Conclusion:The management of Gustilo-Anderson grade 1 to 3A open tibial shaft fractures with primary debridement and locked intramedullary nailing shows good short-term results with low infection and non-union rates despite delay in surgical management or HIV infection. Level of evidence: Level 4Key words: open tibial fractures, intramedullary nails, infection, union

show abstract

“…Many studies have reported an infection rate in the tune of 16-66% in open fractures. [1][2][3][4][5][6][7][8] With modern treatment protocols and availability of better antibiotics, this percentage has decreased significantly but still amounts to a sizeable chunk. This scenario is worse for open diaphyseal tibial fractures as they are associated with a higher contamination, soft tissue damage and skin loss.…”

Section: Introductionmentioning

confidence: 99%

Impact of negative pressure wound therapy on open diaphyseal tibial fractures: A prospective randomized trial

Virani¹,

Dahapute²,

Bava³

et al. 2016

Journal of Clinical Orthopaedics and Trauma

View full text Add to dashboard Cite

The Effect of Time to Definitive Treatment on the Rate of Nonunion and Infection in Open Fractures

Abstract: The risk of developing an adverse outcome was not increased by aggressive debridement/lavage and definitive fixation up to thirteen hours from the time of injury when early prophylactic antibiotic administration and open fracture first aid were instituted.

Cited by 226 publications

References 17 publications

Is the expression of Transforming Growth Factor-Beta1 after fracture of long bones solely influenced by the healing process?

Is the expression of Transforming Growth Factor-Beta1 after fracture of long bones solely influenced by the healing process?

Outcomes of intramedullary nailing for open fractures of the tibial shaft

Impact of negative pressure wound therapy on open diaphyseal tibial fractures: A prospective randomized trial

Contact Info

Product

Resources

About