Emergent irrigation and debridement has been accepted as a mainstay of open fracture treatment
. The purpose of this study was to evaluate the infectious outcome of open tibia
fractures relative to the time from injury to operative irrigation and debridement.
One hundred seventy-eight patients with 191 consecutive fractures were retrospectively reviewed. Of these, 103 patients with 106 fractures were available for this study, with an average follow-up of 10.23 months.
Results revealed 21.7% type I fractures, 43.4% type II fractures, 16.0% type IIIa fractures, 11.3% type IIIb fractures, and 7.5% type IIIc fractures. Of all fracture
types, 22.6% became infected and 5.7% went on to have osteomyelitis. The average time to treatment
was not significantly different in infected versus noninfected fractures across fracture
types. No infection
occurred when the time to surgery was within 2 hours; however, no significant increase in infection
was discovered with respect to patients treated after 6 hours compared with those treated within 6 hours.
The results support the Gustilo grading system of open
fractures as a significant prognostic indicator for infectious complication. We continue to support the emergent treatment
of open tibia