Evidence map›Paper›PMID 28410572›Full record

Observational studyBMC musculoskeletal disorders2017

Incidence of infection following internal fixation of open and closed tibia fractures in India (INFINITI): a multi-centre observational cohort study.

Prakash Doshi, Hitesh Gopalan, Sheila Sprague, Chetan Pradhan, Sunil Kulkarni, Mohit Bhandari

Registry-linked trialAbstract readMulticenter StudyObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in BMC musculoskeletal disorders, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT01691599 (Infection Rates Following Internal Fixation of Open and Closed Tibia Fractures in India), which is not on this map. Cited by 29 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
29citing papers in PubMed, 2 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT01691599 completednot on this map

Infection Rates Following Internal Fixation of Open and Closed Tibia Fractures in India (INFINITI): a Prospective Multi-center Observational Study.

TypeobservationalSponsorAO Clinical Investigation and Publishing DocumentationRan2012 to 2015Enrolled800ConditionsTibia Fracture
3 · Its place in the literature

Who cites it

29 citing papers in PubMed, 2 syntheses or guidelines pooled it.

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  11. Outcomes after primary intramedullary nail fixation of open tibial and femoral fractures in low resource settings.European journal of orthopaedic surgery & traumatology : orthopedie traumatologie · 2023
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Prakash DoshiDivision of Orthopaedic Surgery, McMaster University, Well-Health Building, 293 Wellington Street North, Suite 110, Hamilton, ON, L8L 8E7, Canada.
Hitesh GopalanDivision of Orthopaedic Surgery, McMaster University, Well-Health Building, 293 Wellington Street North, Suite 110, Hamilton, ON, L8L 8E7, Canada.
Sheila SpragueDivision of Orthopaedic Surgery, McMaster University, Well-Health Building, 293 Wellington Street North, Suite 110, Hamilton, ON, L8L 8E7, Canada.
Chetan PradhanDivision of Orthopaedic Surgery, McMaster University, Well-Health Building, 293 Wellington Street North, Suite 110, Hamilton, ON, L8L 8E7, Canada.
Sunil KulkarniDivision of Orthopaedic Surgery, McMaster University, Well-Health Building, 293 Wellington Street North, Suite 110, Hamilton, ON, L8L 8E7, Canada.
Mohit BhandariDivision of Orthopaedic Surgery, McMaster University, Well-Health Building, 293 Wellington Street North, Suite 110, Hamilton, ON, L8L 8E7, Canada. bhandam@mcmaster.ca.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundTrauma is a major public health problem, particularly in India due to the country's rapid urbanization. Tibia fractures are a common and often complicated injury that is at risk of infection following surgical fixation. The primary objectives of this cohort study were to determine the incidence of infection within one year of surgery and to describe the distribution of infections by location and time of diagnosis for tibia fractures in India.

methodsWe conducted a multi-center, prospective cohort study. Patients who presented with an open or closed tibia fracture treated with internal fixation to one of the participating hospitals in India were invited to participate in the study. Participants attended follow-up visits at 3, 6, and 12 months post-surgery, where they were assessed for infections, fracture healing, and health-related quality of life as measured by the EurQol-5 Dimensions (EQ-5D).

resultsSeven hundred eighty-seven participants were included in the study and 768 participants completed the 12 month follow-up. The overall incidence of infection was 2.9% (23 infections). The incidence of infection was 1.6% (10 infections) in closed and 8.0% (13 infections) in open fractures. There were 7 deep and 16 superficial infections, with 5 being early, 7 being delayed, and 11 being late infections. Intra-operative antibiotics were given to 92.1% of participants and post-operative antibiotics were given to 96.8% of participants. Antibiotics were prescribed for an average of 8.3 days for closed fractures and 9.1 days for open fractures. Infected fractures took significantly longer to heal, and participants who had an infection had significantly lower EQ-5D scores.

conclusionsThe incidence of infection within this cohort is similar to those seen in developed countries. The duration of prophylactic antibiotic use was longer than standard practice in North America, raising concern for the potential development of antibiotic resistant microbes within Indian orthopaedic settings. Future research should aim to identify the best practice for antibiotic use in India to ensure that antibiotic usage patterns do not lead to unnecessary overuse, while maintaining a low incidence of infection.

trial registrationNCT01691599 , September 17, 2012.

Indexed as

Fracture HealingAdultAnti-Bacterial AgentsDelayed DiagnosisFemaleFollow-Up StudiesFracture Fixation, InternalFractures, ClosedFractures, OpenHumansIncidenceIndiaMaleMiddle AgedProspective StudiesQuality of LifeAnti-Bacterial AgentsClosed tibia fracturesOpen tibia fracturesWound infection

Identifiers

PMID28410572
PMCPMC5391577

What OpenQuestion holds

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.