The radiological diagnosis of infection

Bhat, Vineet; Gupta, Harun

doi:10.1016/j.mporth.2014.03.001

Cited by 1 publication

(1 citation statement)

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“…6 The following radiologic features were used as indicators of infection: periosteal thickening, lytic lesions, endosteal scalloping and new bone apposition, implant loosening as indicated by lucency around the intramedullary tibial nail associated with cortical thinning, cortical irregularity and subperiosteal new bone formation. 8 During data collection, when looking at the description of the wound, soft tissue damage and periosteal stripping, and reviewing the extent of comminution of the fractures on X-ray (XR), we found some fractures that were initially classified as GA I which were actually GA II , some that were classified as GA II fractures which were actually GA IIIA and some GA IIIA whose severity of injury was also underestimated. We did not have any GA IIIC in the study.…”

Section: Methodsmentioning

confidence: 99%

Open tibial fractures: risk factors for infection in conversion of external fixator to intramedullary nail at a tertiary academic hospital

2018

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Aim: To determine the rate of infection in open tibial fractures treated by conversion of an external fixation into an intramedullary nail, and to identify the factors contributing to the infections. Methods: The study included a total of 52 patients. Multiple variables were assessed as risk factors that could lead to infection in open tibial fractures treated primarily with an external fixator and later converted into an intramedullary nail. The factors looked at were: age, average time taken from injury to debridement, average time taken from admission to debridement, antibiotics administration, facility that admitted the patient before intramedullary nail, average time for conversion of external fixator into intramedullary nail insertion, type of soft tissue management, initial Gustilo and Anderson classification and retrospective re-classification of fractures, existence of superficial sepsis or pin-tract infection, radiologic evidence of infection, the Injury Severity Score and the type of external fixator used. A p value < 0.05 was used as the threshold for level of significance. Results: The average follow-up was 37 weeks (median 24 weeks). We had a 40% infection rate CI [27%, 55%]. Factors that were found to be the most statistically significant (p≤0.05) were amount of soft tissue injury and fracture comminution; this is after the fractures were retrospectively reclassified. All other factors looked at were not statistically significant as risk factors for infection (p>0.05). Conclusion: The study suggests that correct classification of open tibial fractures, with recognition of soft tissue injury and bone comminution, is important in reducing infection rates and in ensuring proper initial management of these fractures. Treatment should be based on the classification done in theatre during the initial debridement, rather than on presentation in the trauma unit.

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Section: Methodsmentioning

confidence: 99%