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The Gustilo–Anderson classification system as predictor of nonunion and infection in open tibia fractures

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European Journal of Trauma and Emergency Surgery Aims and scope Submit manuscript

Abstract

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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Author information

Authors and Affiliations

  1. The Vanderbilt Orthopaedic Institute Center for Health Policy, Vanderbilt University, Suite 4200, South Tower, MCE, Nashville, TN, 37221, USA

    R. V. Thakore, E. L. Francois, S. K. Nwosu, B. Attum, M. A. Siuta, M. A. Benvenuti, A. K. Smith, M. S. Shen, I. Mousavi, W. T. Obremskey & M. K. Sethi

  2. Department of Orthopaedics and Rehabilitation, University of Wisconsin Hospital and Clinics, 1685 Highland Ave., Madison, WI, 53705, USA

    P. S. Whiting

Authors
  1. R. V. Thakore
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  2. E. L. Francois
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  3. S. K. Nwosu
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  4. B. Attum
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  6. M. A. Siuta
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  7. M. A. Benvenuti
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  8. A. K. Smith
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  9. M. S. Shen
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  10. I. Mousavi
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  11. W. T. Obremskey
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  12. M. K. Sethi
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Corresponding author

Correspondence to M. K. Sethi.

Ethics declarations

This study was performed in accordance with the relevant regulations of the US Health Insurance Portability and Accountability Act (HIPPA) and the ethical standards of the 1964 Declaration of Helsinki. The protocol was approved by the Vanderbilt Institution Review Board.

Conflict of interest

Author William Obremskey has previously been consulted for biometrics, provided expert testimony in legal matters, was committee chair of the OTA and SEFC, and has a grant from the Department of Defense. Rachel V. Thakore, Elvis L. Francois, Paul S. Whiting, Michael A. Siuta, Michael A. Benvenuti, Anne K. Smith, Basem Attum, Samuel K. Nwosu, and Manish K. Sethi declare that they have no conflict of interest.

Source of funding

No grant money or other supports (technical, corporate) were involved for this research study.

Copyrighted material/consent forms

This study used no previously copyrighted materials or signed patient consent forms. This study was retrospective in nature.

IRB approval

This study has approval from the Vanderbilt IRB.

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Thakore, R.V., Francois, E.L., Nwosu, S.K. et al. The Gustilo–Anderson classification system as predictor of nonunion and infection in open tibia fractures. Eur J Trauma Emerg Surg 43, 651–656 (2017). https://doi.org/10.1007/s00068-016-0725-y

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  • DOI: https://doi.org/10.1007/s00068-016-0725-y

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