The Effect of Treatment Delays on Fracture-related Infection in Open Tibia Shaft Fractures: A Retrospective Cohort Study.

IF 1.3 Q3 ORTHOPEDICS

Strategies in Trauma and Limb Reconstruction Pub Date : 2025-01-01 Epub Date: 2025-08-18 DOI:10.5005/jp-journals-10080-1640

Frans W Kock, Tinus R Basson, Marilize C Burger, Nando Ferreira

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引用次数: 0

Abstract

Background: Controversy remains on the most effective method of treating open tibia shaft fractures. The timing of the different treatment variables remains at the heart of this dispute. This study aimed to investigate outcomes of open tibial shaft fractures. Specific objectives were to determine the association of time delay to antibiotic administration, surgical debridement, definitive skeletal stabilisation and soft tissue reconstruction, and the development of fracture-related infection (FRI).

Materials and methods: A total of 227 patients with 237 open tibia shaft fractures were included. The time from arrival to (1) antibiotic administration (<3 hours vs >3 hours); (2) primary debridement in theatre (<24 hours vs >24 hours); (3) definitive skeletal stabilization (<5 days vs >5 days); (4) definitive soft tissue reconstruction (<5 vs >5 days); and (5) time to union was recorded. The number of debridements and the length of hospital stay were also recorded.

Results: Patients who waited more than 5 days for definitive skeletal fixation or soft tissue reconstruction had a significant increase in FRI [odds ratio (OR) 4.7, 95% confidence intervals (CI): 2.0-10.9 and OR 4.7, 95% CI: 2.0-11.0, respectively]. Patients who underwent more than two formal debridements also had a higher risk of developing FRI than those who only had ≤2 debridements (OR 15.6, 95% CI: 5.8-41.6).

Conclusion: Time delays in managing open tibia shaft fractures are associated with an increased risk of FRI. Definitive soft tissue reconstruction and skeletal stabilisation should not be delayed for more than 5 days.

Clinical significance: Fracture-related infection following open tibia shaft fractures can be mitigated by reducing treatment delays, specific to definitive soft tissue reconstruction and skeletal stabilisation.

How to cite this article: Kock FM, Basson TR, Burger MC, et al. The Effect of Treatment Delays on Fracture-related Infection in Open Tibia Shaft Fractures: A Retrospective Cohort Study. Strategies Trauma Limb Reconstr 2025;20(1):25-30.

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治疗延迟对开放性胫骨干骨折骨折相关感染的影响：一项回顾性队列研究。

背景：关于治疗开放性胫骨干骨折的最有效方法仍有争议。不同治疗变量的时机仍然是这场争论的核心。本研究旨在探讨开放性胫干骨折的预后。具体目的是确定时间延迟与抗生素给药、手术清创、最终骨骼稳定和软组织重建以及骨折相关感染（FRI）的发展之间的关系。材料与方法：237例开放性胫骨干骨折患者共227例。到货至(1)给药时间（3小时）；(2)手术室初级清创（24小时）；(3)明确的骨骼稳定（5天）；(4)最终软组织重建（5天）；(5)记录到工会的时间。同时记录清创次数和住院时间。结果：等待超过5天确定骨骼固定或软组织重建的患者FRI显著增加[比值比（or） 4.7, 95%可信区间（CI）： 2.0-10.9和or 4.7, 95% CI: 2.0-11.0]。接受两次以上正式清创的患者发生FRI的风险也高于仅接受≤2次清创的患者（OR: 15.6, 95% CI: 5.8-41.6）。结论：治疗开放性胫骨干骨折的时间延迟与FRI风险增加有关，确定软组织重建和骨骼稳定不应延迟超过5天。临床意义：开放性胫骨干骨折后骨折相关感染可通过减少治疗延误，特别是明确软组织重建和骨骼稳定来减轻。如何引用这篇文章：Kock FM， Basson TR， Burger MC等。治疗延迟对开放性胫骨干骨折骨折相关感染的影响：一项回顾性队列研究。创伤肢体重建2025；20(1):25-30。

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

Strategies in Trauma and Limb Reconstruction Medicine-Orthopedics and Sports Medicine

CiteScore

1.50

自引率

0.00%

发文量

期刊介绍： Strategies in Trauma and Limb Reconstruction is dedicated to surgeons, allied medical professionals and researchers in the field of orthopaedics and trauma. The scope of the journal is to discuss the fields of skeletal injury, and the complications thereof, congenital and acquired limb deformities and deficiencies, and orthopaedic-related infection, together with their surgical and non-surgical treatments. The journal publishes original articles, reviews, case reports, descriptions of new or recognised treatment techniques, forum discussions of clinical scenarios and relevant correspondence. It aims to provide a widely accessible source of useful information to practitioners in the field through the problem- or technique-based approach of published articles.