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Factors influencing infection in 10 years of battlefield open tibia fractures.

Penn-Barwell JG, Bennett PM, Mortiboy DE, Fries CA, Groom AF, Sargeant ID - Strategies Trauma Limb Reconstr (2016)

Bottom Line: Bone loss was significantly associated with subsequent infection (p < 0.0001, Fisher's exact test).Most infection in combat open tibia fractures is caused by familiar organisms, i.e. S. aureus.While the overall severity of a casualty's injuries was not associated with infection, the degree of bone loss from the fracture was.

View Article: PubMed Central - PubMed

Affiliation: National Institute of Health Research, Surgical Reconstruction and Microbiology Research Centre (NIHR SRMRC), Birmingham, UK. jowanpb@me.com.

ABSTRACT
The aim of this study was to characterise severe open tibial shaft fractures sustained by the UK military personnel over 10 years of combat in Iraq and Afghanistan. The UK military Joint Theatre Trauma Registry was searched for all such injuries, and clinical records were reviewed for all patients. One hundred Gustilo-Anderson III tibia fractures in 89 patients were identified in the 10 year study period; the majority sustained injuries through explosive weapons (63, 68 %) with the remainder being injured from gunshot wounds. Three fractures were not followed up for 12 months and were therefore excluded. Twenty-two (23 %) of the remaining 97 tibial fractures were complicated by infection, with S. aureus being the causative agent in 13/22 infected fractures (59 %). Neither injury severity, mechanism, the use of an external fixator, the need for vascularised tissue transfer nor smoking status was associated with subsequent infection. Bone loss was significantly associated with subsequent infection (p < 0.0001, Fisher's exact test). This study presents 10 years of open tibial fractures sustained in Iraq and Afghanistan. Most infection in combat open tibia fractures is caused by familiar organisms, i.e. S. aureus. While the overall severity of a casualty's injuries was not associated with infection, the degree of bone loss from the fracture was.

No MeSH data available.


Related in: MedlinePlus

Temporal distribution of casualties over the decade of the study period country of injury shown
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Fig1: Temporal distribution of casualties over the decade of the study period country of injury shown

Mentions: The JTTR search identified 445 patients with bony injury affecting the knee, tibia or ankle. Following case note and X-ray review, 353 cases were excluded according to the pre-defined criteria. Eighty-nine patients with 100 severe open tibial fractures were therefore eligible for inclusion (eleven patients with bilateral fractures). The median age was 25 years (IQR 21.3–29.0, mean = 26.0, SD = 5.1). Nine patients were wounded while on service in Iraq with the remainder injured in Afghanistan. The temporal distribution of casualties over the decade is shown in Fig. 1 with the peak occurring in 2007.Fig. 1


Factors influencing infection in 10 years of battlefield open tibia fractures.

Penn-Barwell JG, Bennett PM, Mortiboy DE, Fries CA, Groom AF, Sargeant ID - Strategies Trauma Limb Reconstr (2016)

Temporal distribution of casualties over the decade of the study period country of injury shown
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4814384&req=5

Fig1: Temporal distribution of casualties over the decade of the study period country of injury shown
Mentions: The JTTR search identified 445 patients with bony injury affecting the knee, tibia or ankle. Following case note and X-ray review, 353 cases were excluded according to the pre-defined criteria. Eighty-nine patients with 100 severe open tibial fractures were therefore eligible for inclusion (eleven patients with bilateral fractures). The median age was 25 years (IQR 21.3–29.0, mean = 26.0, SD = 5.1). Nine patients were wounded while on service in Iraq with the remainder injured in Afghanistan. The temporal distribution of casualties over the decade is shown in Fig. 1 with the peak occurring in 2007.Fig. 1

Bottom Line: Bone loss was significantly associated with subsequent infection (p < 0.0001, Fisher's exact test).Most infection in combat open tibia fractures is caused by familiar organisms, i.e. S. aureus.While the overall severity of a casualty's injuries was not associated with infection, the degree of bone loss from the fracture was.

View Article: PubMed Central - PubMed

Affiliation: National Institute of Health Research, Surgical Reconstruction and Microbiology Research Centre (NIHR SRMRC), Birmingham, UK. jowanpb@me.com.

ABSTRACT
The aim of this study was to characterise severe open tibial shaft fractures sustained by the UK military personnel over 10 years of combat in Iraq and Afghanistan. The UK military Joint Theatre Trauma Registry was searched for all such injuries, and clinical records were reviewed for all patients. One hundred Gustilo-Anderson III tibia fractures in 89 patients were identified in the 10 year study period; the majority sustained injuries through explosive weapons (63, 68 %) with the remainder being injured from gunshot wounds. Three fractures were not followed up for 12 months and were therefore excluded. Twenty-two (23 %) of the remaining 97 tibial fractures were complicated by infection, with S. aureus being the causative agent in 13/22 infected fractures (59 %). Neither injury severity, mechanism, the use of an external fixator, the need for vascularised tissue transfer nor smoking status was associated with subsequent infection. Bone loss was significantly associated with subsequent infection (p < 0.0001, Fisher's exact test). This study presents 10 years of open tibial fractures sustained in Iraq and Afghanistan. Most infection in combat open tibia fractures is caused by familiar organisms, i.e. S. aureus. While the overall severity of a casualty's injuries was not associated with infection, the degree of bone loss from the fracture was.

No MeSH data available.


Related in: MedlinePlus