The contribution of open extremity fractures to infection in multiply injured patients

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Pseudofracture: An Acute Peripheral Tissue Trauma Model
10:08

Pseudofracture: An Acute Peripheral Tissue Trauma Model

Published on: April 18, 2011

W Naziri1, W G Cheadle, D H Livingston

  • 1Department of Surgery, University of Louisville School of Medicine, KY.

Injury
|April 1, 1994
PubMed

Insights

Contaminated open fractures rarely cause infection in multiply injured patients. Excluding these fractures from clinical trials improves accuracy for infection risk and survival predictions using the Outcome Predictive Score.

Area of Science:

  • Trauma surgery
  • Infectious disease epidemiology
  • Clinical trial design

Background:

  • The Outcome Predictive Score is used to assess prognosis in patients with multiple injuries.
  • The role of contaminated open fractures in predicting outcomes for these patients is not well-defined.

Purpose of the Study:

  • To evaluate if contaminated open fractures are a reliable factor in calculating the Outcome Predictive Score for multiply injured patients.
  • To determine the actual infection rate associated with open fractures in this patient cohort.

Main Methods:

  • Retrospective study of 41 patients with multiple injuries.
  • Primary source of contamination in all patients was an open extremity fracture.
  • Analysis of osteomyelitis development and its impact on the Outcome Predictive Score.

Main Results:

  • Only one out of 41 patients (2.4%) developed osteomyelitis.
  • The infection rate from open fractures in multiply injured patients is minimal.
  • Including open fractures overestimates survival rates when using the Outcome Predictive Score.

Conclusions:

  • Contaminated open fractures should be excluded as an entry criterion in future clinical trials involving multiply injured patients.
  • Exclusion enhances the accuracy of infection likelihood assessments and survival predictions.
  • This exclusion refines the utility of the Outcome Predictive Score in trauma research.

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