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Children with open tibial fractures show significantly lower infection rates than adults: clinical comparative study

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Abstract

Purpose

The purpose of this study is to investigate and compare the surgical site infection (SSI) rates of children and adults after open tibia fracture at a single medical centre.

Methods

A retrospective study was performed on patients who sustained open tibia fractures and who received treatment at our hospital from 2012 to 2016. Data on age, gender, fracture site, Gustilo-Anderson grade, treatment management, and culture results from the infection site were recorded.

Results

Overall, 37 children with a mean age of 7.19 ± 2.28 years and 89 adults with a mean age of 40.38 ± 13.53 years were enrolled. The rate of SSIs was 13.5% (6/37) in children, which was significantly lower than the 21.3% (19/89) rate in adults (p < 0.001). The mean number of days to discharge was 12.86 ± 10.25 in children, which was significantly lower than the mean of 28.67 ± 16.92 days in adults (p < 0.001). Furthermore, the average waiting time for soft tissue recovery before definitive surgery was 1.41 ± 1.79 and 8.42 ± 4.38 days in children and in adults, respectively, and the difference was significant (p < 0.001). Early infection occurred more frequently in adults (5/19) than in children (0/6). Staphylococcus aureus was the most commonly found pathogen in both groups.

Conclusion

The SSI rate of paediatric patients after open tibia fracture fixation is significantly lower than that of adults, and the prognosis of the former is superior. The results indicate a superior ability of soft tissue recovery and infection resistance after open tibia fracture fixation among children.

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Author notes

  1. Hui Chen and Shunyou Chen contributed equally to this study as co-first authors.

Authors and Affiliations

  1. Department of Orthopedics and Traumatology, Nanfang Hospital, Southern Medical University, Guangzhou, 510515, Guangdong, China

    Hui Chen, Shunyou Chen & Bin Yu

  2. Guangdong Provincial Key Laboratory of Bone and Cartilage Regenerative Medicine, Nanfang Hospital, Southern Medical University, Guangzhou, 510515, Guangdong, China

    Hui Chen, Shunyou Chen & Bin Yu

  3. Department of Orthopedics, Fuzhou Second Hospital Affiliated to Xiamen University, Fuzhou, 350007, Fujian, China

    Hui Chen, Shunyou Chen, Yi Shi & Yunan Lu

Authors
  1. Hui Chen
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  2. Shunyou Chen
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  3. Yi Shi
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  4. Yunan Lu
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  5. Bin Yu
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Corresponding author

Correspondence to Bin Yu.

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Chen, H., Chen, S., Shi, Y. et al. Children with open tibial fractures show significantly lower infection rates than adults: clinical comparative study. International Orthopaedics (SICOT) 43, 713–718 (2019). https://doi.org/10.1007/s00264-018-3996-6

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  • DOI: https://doi.org/10.1007/s00264-018-3996-6

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