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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

Scatter plot showing the New Injury Severity Score by infected and uninfected groups. The horizontal lines denote the median and the inter-quartile range
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Fig2: Scatter plot showing the New Injury Severity Score by infected and uninfected groups. The horizontal lines denote the median and the inter-quartile range

Mentions: The median NISS overall was 17 (IQR = 12–22). In the 22 infected cases, the median NISS was 20 (IQR = 15–29) and 17 (IQR = 11–22), in the 75 uninfected fractures (p = 0.0469, Mann–Whitney) as shown in Fig. 2. This difference was not regarded as statistically significant due to the Bonferroni correction that was applied.Fig. 2


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)

Scatter plot showing the New Injury Severity Score by infected and uninfected groups. The horizontal lines denote the median and the inter-quartile range
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

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

Fig2: Scatter plot showing the New Injury Severity Score by infected and uninfected groups. The horizontal lines denote the median and the inter-quartile range
Mentions: The median NISS overall was 17 (IQR = 12–22). In the 22 infected cases, the median NISS was 20 (IQR = 15–29) and 17 (IQR = 11–22), in the 75 uninfected fractures (p = 0.0469, Mann–Whitney) as shown in Fig. 2. This difference was not regarded as statistically significant due to the Bonferroni correction that was applied.Fig. 2

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