ArticleJournal of clinical orthopaedics and trauma2022
Definitive fixation of open tibia fractures: Does reopening the traumatic wound increase complication rates?
Article in Journal of clinical orthopaedics and trauma, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
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Who cites it
3 citing papers in PubMed.
- Comparison between early versus delayed (staged) plate fixation in the treatment of pilon (tibial plafond) fractures: a systematic review and meta-analysis.Musculoskeletal surgery · 2026Review
- Open Tibial Fractures Part 2: A Narrative Review of Definitive Treatment and Potential Applicability to the Southern African Context.Orthopedic research and reviews · 2026Review
- Open Tibial Fractures Part 1: A Narrative Review of Initial Treatment and Potential Applicability to the Southern African Context.Orthopedic research and reviews · 2025Review
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Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundIt is unknown if surgical approach or use of previous traumatic wounds for open fracture instrumentation has an impact on patient complications or outcomes. This study sought to compare infection and nonunion rates in the staged treatment of open tibia fractures where the traumatic wound was reopened during definitive fixation versus when they were not.
methodsA retrospective review was performed on all patients at a single institution level 1 trauma center. All patients who had a minimum of 1 year clinical and radiographic outcomes were included. Primary outcome measures were incidence of infection and nonunion. Groups of patients were compared based on surgical approach for definitive fixation.
resultsA total of 96 patients were included - 48 patients received definitive treatment and wound closure during initial management of the open fracture (group 1), 22 patients had staged fixation through new incisions (group 2), and 26 patients had their traumatic wound reopened during definitive fixation (group 3). Rates of infection were 10.4%, 31.8% and 11.5% respectively (p = 0.15). Rates of nonunion were 20.8%, 27.3% and 30.8% (p = 1.0). No statistically significant differences in regards to primary outcomes were found between the staged fixation groups. Multiple logistic regression also showed no difference in infection or nonunion when controlling for known risk factors.
conclusionFor open tibia fractures that underwent staged fixation, no significant differences in infection or nonunion were observed between procedures that involved reopening the traumatic wound versus procedures performed through new incisions. The presence of a distal tibia periarticular fracture was found to be independently associated with infection risk.
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