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The Gustilo-Anderson classification system as predictor of nonunion and infection in open tibia fractures
R V Thakore1, E L Francois1, S K Nwosu1
1The Vanderbilt Orthopaedic Institute Center for Health Policy, Vanderbilt University, Suite 4200, South Tower, MCE, Nashville, TN, 37221, USA.
Purpose:
We sought to conduct the largest retrospective study to date of open tibia fractures and describe the incidence of complications and evaluate the potential predictive risk factors for complications.
Methods:
Patients with open tibia fractures treated with reamed intramedullary nail (IMN) across a 10-year period were evaluated. Patient charts were reviewed for demographics, type of open fracture (T), comorbidities, and postoperative complications. A multivariate model was conducted to determine the risk factors for each type of complication.
Results:
Of the 486 patients with open tibia fractures, 13 % (n = 64) had infections, 12 % (n = 56) had nonunions, and 1 % (n = 7) had amputations. TIII fractures had much higher rates of each complication than TI and TII fractures. Fracture type was the only significant risk factor for both nonunion and infection.
Conclusion:
Our study found that the Gustilo grade of open tibia fracture is by far the greatest predictor of nonunion and infection.
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