Infection Rate Amongst Open Fractures of Long Bone Managed by Primary Osteosynthesis: A Prospective Study

Abstract

Background: Managing an open fracture poses greatest challenge to an orthopaedic surgeon. This is because it requires management of contaminated soft tissue injury that involves skin, muscles and various neurovascular structures and also management of underlying fracture. The aim of the present study was to evaluate the efficacy of primary osteosynthesis and early wound management in treatment of complex open fractures

Materials & Methods: The present study was conducted in the Department of Orthopaedics, College of Medical Sciences, Amargarh, Sihor, Bhavnagar, Gujrat, India. Complete history of all the patients was obtained followed by complete general and local examination of the patient. Fractures were classified based on Gustilo-Anderson classification.Internal fixation was under aseptic conditions. The grossly contaminated and non viable tissue was removed. After fixation the wound was closed. All the results were arranged in a tabulated form and analysed using SPSS software. Probability value of less than 0.05 was considered significant.

Results: The present study consisted of 60 subjects, out of these there were 73.3% males (n=44) and 26.7% females (n=16). The patients were aged between 10- 60 years. Majority of patients were aged between 26- 41 years (n=40). There were 25% patients (n=15) who were aged between 42-57 years. There were 8 cases that belonged to Grade II who had infection and all the 12 cases of Grade III had infection. Out of total of 60 cases, there were 20 cases (33.33%) that had infection.

Conclusion: Appropriate consideration should be given to the time of presentation of fracture. This can significantly reduce the risk of infection. Grade III fractures should be allowed to heal by secondary intention.

 

Keyword: Contaminated, Fracture,Infection,Orthopaedic.