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Fractures: Bone Repair

Fractures: Bone Repair

Treatment for a fracture is based on the type of break, the bone affected, and the patient's age.
Minor fractures with no bone displacement are treated by immobilizing the fractured bone using a cast or splint. However, in the case of fractures with displaced bones, the broken bones are repositioned before immobilization to ensure successful healing without deformation and loss of function. The realignment of fractured bone ends is performed through a process called reduction. If the...

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Fabella and patella variants: radiographic prevalence, distribution and clinical relevance in a population of black african descent.

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Creating Rigidly Stabilized Fractures for Assessing Intramembranous Ossification, Distraction Osteogenesis, or Healing of Critical Sized Defects

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Primary and Delayed Primary Wound Closure in Low Energy Open Tibia Shaft Fracture: Randomized Controlled Study.

A Adedire¹, K S Oluwadiya², A Ajibade¹

¹Department of Surgery, Osun State University Teaching Hospital, Osogbo, Osun State. Tel: 08062586085.

West African Journal of Medicine

|May 20, 2025

Summary

Primary wound closure for low-energy open tibia shaft fractures offers a shorter healing time and reduced treatment costs compared to delayed closure. This approach is recommended even in resource-limited settings for managing open fractures.

Keywords:

Management Open fracture Tibia shaft Wound closure

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Published on: November 13, 2016

Area of Science:

Orthopedic Surgery
Trauma Management
Wound Healing

Background:

Delayed wound closure has been standard for open fractures, particularly before antibiotics.
Primary wound closure is underutilized for low-energy open tibia shaft fractures, even with antibiotic availability, especially in developing nations.

Purpose of the Study:

To compare the efficacy of primary versus delayed primary wound closure in treating Gustilo-Anderson type I and II tibia fractures.
To evaluate infection rates, wound healing duration, hospital stay, and treatment costs.

Main Methods:

A randomized prospective intervention study involving 64 patients with Gustilo-Anderson type I and II tibia fractures.
Patients were randomized into two groups: primary wound closure and delayed primary wound closure.
Data on infection rates, healing times, hospital stay, and costs were collected and analyzed.

Main Results:

The infection rate was 9.6% for primary closure versus 3.0% for delayed primary closure.
Primary closure resulted in a shorter mean duration of wound healing (14.8 days) compared to delayed closure (16.1 days).
Primary closure was associated with significantly lower treatment costs (N34,487) than delayed closure (N40,536).

Conclusions:

Primary wound closure is more cost-effective and leads to faster wound healing for low-energy open tibia shaft fractures.
The study recommends the adoption of primary wound closure for these fractures, including in low and middle-income countries.