Does the OTA Open Fracture Classification Align With the Gustilo-Anderson Classification? A Study of 2215 Open Fractures.

IF 1.6 3区医学 Q3 ORTHOPEDICS

Journal of Orthopaedic Trauma Pub Date : 2024-02-01 DOI:10.1097/BOT.0000000000002731

Murali Kovvur, Kristin E Turner, Joshua E Lawrence, Robert V O'Toole, Nathan N O'Hara, Gerard P Slobogean

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引用次数: 0

Abstract

Objectives: To characterize the Orthopaedic Trauma Association Open Fracture Classification (OTA-OFC) and Gustilo-Anderson classification of open extremity fractures and determine if there is meaningful alignment between these grading systems.

Methods:

Design: Retrospective case series.

Setting: Level I academic trauma center.

Patient selection criteria: Adult patients with at least 1 operatively treated open extremity fracture and surgeon-assigned OTA-OFC and Gustilo-Anderson classification.

Outcome measures and comparisons: Frequency, distribution, and association measures of OTA-OFC category scores and Gustilo-Anderson classification types.

Results: Two thousand twenty-seven patients (mean age, 43.1 ± 17.5 years) with 2215 fractures were included. Gustilo-Anderson type I or II fractures (n = 961; 43%) most frequently had the least severe scores for all OTA-OFC categories. Type IIIA fractures (n = 978; 44%) were most often assigned intermediate scores for OTA-OFC Bone Loss (n = 564; 58%). Type IIIB fractures (n = 204, 9%) were most often assigned intermediate OTA-OFC Skin scores (n = 120; 59%). Type IIIC fractures (n = 72; 3%) were most often assigned the most severe OTA-OFC Arterial score (n = 60; 83%). In the multivariable model, OTA-OFC Contamination scores showed little association (β = 0.05; 95% confidence interval [CI], 0.01-0.09) with Gustilo-Anderson classification severity. Conversely, higher OTA-OFC Arterial (β = 0.50; 95% CI 0.44-0.56) and Skin (β = 0.46; 95% CI, 0.40-0.51) scores were strongly associated with more severe Gustilo-Anderson classifications.

Conclusions: OTA-OFC Contamination scores were weakly associated with Gustilo-Anderson classification severity for open fractures. The study findings suggest that the current Gustilo-Anderson classification does not adequately account for injury contamination, a known predictor of infection.

Level of evidence: Diagnostic Level IV. See Instructions for Authors for a complete description of levels of evidence.

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OTA开放性骨折分类与gustillo - anderson分类一致吗?2215例开放性骨折的研究。

目的:研究骨科创伤协会开放性骨折分类(OTA-OFC)和Gustilo-Anderson开放性骨折分类，并确定这些分级系统之间是否有意义的一致性。方法:设计:回顾性病例系列。单位:一级学术创伤中心。患者选择标准:至少有一例手术治疗过的开放性肢体骨折的成年患者，并有外科医生指定的OTA-OFC和gustillo - anderson分类。结果测量和比较:OTA-OFC分类得分和Gustilo-Anderson分类类型的频率、分布和关联测量。结果:共纳入患者2027例(平均年龄43.1±17.5岁)，骨折2215例。gustillo - anderson I型或II型骨折(n = 961;43%)在所有OTA-OFC类别中得分最低。IIIA型骨折(n = 978;44%)最常被评为OTA-OFC骨质流失的中间分数(n = 564;58%)。IIIB型骨折(n = 204,9%)最常被分配中等OTA-OFC Skin评分(n = 120;59%)。IIIC型骨折(n = 72;3%)最常被分配为最严重的OTA-OFC动脉评分(n = 60;83%)。在多变量模型中，OTA-OFC污染评分相关性不大(β = 0.05;95%可信区间[CI]， 0.01-0.09)。相反，动脉血ta - ofc升高(β = 0.50;95% CI, 0.44-0.56)和Skin (β = 0.46;95% CI, 0.40-0.51)评分与更严重的Gustilo-Anderson分类密切相关。结论:开放性骨折的OTA-OFC污染评分与Gustilo-Anderson分级严重程度弱相关。研究结果表明，目前的古斯蒂洛-安德森分类并没有充分考虑损伤污染，这是已知的感染预测因素。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Orthopaedic Trauma 医学-运动科学

CiteScore

3.90

自引率

8.70%

发文量

396

审稿时长

3-8 weeks

期刊介绍： Journal of Orthopaedic Trauma is devoted exclusively to the diagnosis and management of hard and soft tissue trauma, including injuries to bone, muscle, ligament, and tendons, as well as spinal cord injuries. Under the guidance of a distinguished international board of editors, the journal provides the most current information on diagnostic techniques, new and improved surgical instruments and procedures, surgical implants and prosthetic devices, bioplastics and biometals; and physical therapy and rehabilitation.