The epidemiology of open fractures in adults. A 15-year review

Court-Brown, Charles M.; Bugler, K.E.; Clement, Nicholas D.; Duckworth, Andrew D.; McQueen, Margaret M.

doi:10.1016/j.injury.2011.12.007

Cited by 255 publications

(209 citation statements)

References 8 publications

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“…While multiple factors may influence open fracture rate, a recent study reported an incidence of 30.7/ 10 5 /year. 1 Open fractures have multiple causes, often occur in extremities, and are most severe in lower legs and feet (Fig. 1A-C).…”

Section: Scope and Significancementioning

confidence: 99%

Current Concepts and Ongoing Research in the Prevention and Treatment of Open Fracture Infections

Hannigan

Pulos

Grice

et al. 2015

Advances in Wound Care

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Significance: Open fractures are fractures in which the bone has violated the skin and soft tissue. Because of their severity, open fractures are associated with complications that can result in increased lengths of hospital stays, multiple operative interventions, and even amputation. One of the factors thought to influence the extent of these complications is exposure and contamination of the open fracture with environmental microorganisms, potentially those that are pathogenic in nature. Recent Advances: Current open fracture care aims to prevent infection by wound classification, prophylactic antibiotic administration, debridement and irrigation, and stable fracture fixation. Critical Issues: Despite these established treatment paradigms, infections and infection-related complications remain a significant clinical burden. To address this, improvements need to be made in our ability to detect bacterial infections, effectively remove wound contamination, eradicate infections, and treat and prevent biofilm formation associated with fracture fixation hardware. Future Directions: Current research is addressing these critical issues. While culture methods are of limited value, culture-independent molecular techniques are being developed to provide informative detection of bacterial contamination and infection. Other advanced contamination-and infection-detecting techniques are also being investigated. New hardware-coating methods are being developed to minimize the risk of biofilm formation in wounds, and immune stimulation techniques are being developed to prevent open fracture infections. SCOPE AND SIGNIFICANCEOpen fractures occur when bone is exposed through skin as a result of bone breaking through skin or wound penetration with fractured bone exposure. While multiple factors may influence open fracture rate, a recent study reported an incidence of 30.7/ 10 5

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Section: Scope and Significancementioning

confidence: 99%

Current Concepts and Ongoing Research in the Prevention and Treatment of Open Fracture Infections

Hannigan

Pulos

Grice

et al. 2015

Advances in Wound Care

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“…Fractures of the tibial diaphysis constitute the most common open long-bone fracture, occurring in approximately two per 10,000 persons per year in the developed world [8][9][10]. There is also a growing epidemic of open tibial fractures in populations in low-and middle-income countries [6,24].With rapidly increasing rates of motorization occurring in developing countries [24], identifying optimal treatment of fractures of the tibial diaphysis is a global surgical priority.…”

Section: Introductionmentioning

confidence: 99%

Which Surgical Treatment for Open Tibial Shaft Fractures Results in the Fewest Reoperations? A Network Meta-analysis

Foote

Guyatt

Vignesh

et al. 2015

Clinical Orthopaedics &Amp; Related Research

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Background Open tibial shaft fractures are one of the most devastating orthopaedic injuries. Surgical treatment options include reamed or unreamed nailing, plating, Ender nails, Ilizarov fixation, and external fixation. Using a network meta-analysis allows comparison and facilitates pooling of a diverse population of randomized trials across these approaches in ways that a traditional meta-analysis does not. Questions/purposes Our aim was to perform a network meta-analysis using evidence from randomized trials on the relative effect of alternative approaches on the risk of unplanned reoperation after open fractures of the tibial diaphysis. Our secondary study endpoints included malunion, deep infection, and superficial infection. Methods A network meta-analysis allows for simultaneous consideration of the relative effectiveness of multiple treatment alternatives. To do this on the subject of surgical treatments for open tibial fractures, we began with systematic searches of databases (including EMBASE and MEDLINE) and performed hand searches of orthopaedic journals, bibliographies, abstracts from orthopaedic conferences, and orthopaedic textbooks, for all relevant material published between 1980 and 2013. Two authors independently screened abstracts and manuscripts and extracted the data, three evaluated the risk of bias in individual studies, and two applied Grading of Recommendation Assessment, Development and Evaluation (GRADE) criteria to bodies of evidence. We included all randomized and quasirandomized trials comparing two (or more) surgical treatment options for open tibial shaft fractures in predominantly (ie, [ 80%) adult patients. We calculated pooled estimates for all direct comparisons and conducted a network meta-analysis combining direct and indirect evidence for all 15 comparisons between six stabilization strategies. Fourteen trials published between Each author certifies that he or she has no commercial associations (eg, consultancies, stock ownership, equity interest, patent/licensing arrangements, etc) that might pose a conflict of interest in connection with the submitted article. All ICMJE Conflict of Interest Forms for authors and Clinical Orthopaedics and Related Research 1 editors and board members are on file with the publication and can be viewed on request. This study was performed at

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“…Incidence of open fracture rate is increasing, especially in working age groups in industrialized society. In working age groups, high-energy injury is the major cause of open fracture and in older age groups, low energy open fractures are common [2] . The choice of the optimal implant when managing open fractures have historically been one of the most controversial issues in fracture treatment.…”

Section: Introductionmentioning

confidence: 99%

Supracutaneous plate: A comparable alternative to external fixator in the treatment of open fracture

Thein¹,

Mohamad²,

Lwin³

et al. 2018

Int. J. Orthop. Sci.

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Open fracture is one of the common health care problems in clinical orthopedic practice. Incidence of open fracture rate is increasing, especially in working age groups in industrialized society. Treatment of open fractures is still challenging since surgeons have to tackle not only fracture and also risk of infection, soft tissue coverage and neurovascular injury. Traditionally, external fixator (EF) device was used to fix the open fracture as an emergency or definitive management. In recent years, there was the introduction of locked compression plate (LCP) as an alternative to the conventional external fixator. There are not too many studies regarding the outcome, biomechanics and complications regarding LCP as an external fixator. Based on the available resources, we have reviewed some journals. We would like to comment that usage of LCP as an external fixator in the treatment of long bone fractures shows acceptable outcome. There is no significant difference in operation time between LCP and EF. The rates of union and complication are comparable to that of the conventional external fixator. There is no enough report about a biomechanical comparison study between LCP and EF. Patient acceptance may be higher in LCP than in EF however; there is very little research for the time being. We would like to recommend further research in this area.

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The epidemiology of open fractures in adults. A 15-year review

Cited by 255 publications

References 8 publications

Current Concepts and Ongoing Research in the Prevention and Treatment of Open Fracture Infections

Current Concepts and Ongoing Research in the Prevention and Treatment of Open Fracture Infections

Which Surgical Treatment for Open Tibial Shaft Fractures Results in the Fewest Reoperations? A Network Meta-analysis

Supracutaneous plate: A comparable alternative to external fixator in the treatment of open fracture

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