The Use of Qualitative Cultures for Detecting Infection in Open Tibial Fractures

Purpose. To determine the role of qualitative cultures for detecting infection in open tibial fractures. Methods. From January 2003 to December 2004, 95 men and 13 women (mean age, 34 years) with open tibial fractures in one or both limbs and without any other sites of infection were prospectively studied. Patients who had been treated with intravenous or oral antibiotics before presentation and/or had undergone debridement or other surgery were excluded. Results. Infection was not correlated with age, sex, interval from injury to debridement, and cause of fracture. The association of infection with predebridement cultures was stronger (odds ratio=12.5) than that with postdebridement cultures (odds ratio=4.7). Conclusion. Pre- and post-debridement cultures have a role in detecting infection in open tibial fractures. For detecting infection, predebridement cultures have better sensitivity, while postdebridement cultures have better specificity.

[1]  R. Sen,et al.  Bacterial Load in Tissues and its Predictive Value for Infection in Open Fractures , 2000, Journal of orthopaedic surgery.

[2]  Jackson Lee,et al.  Efficacy of Cultures in the Management of Open Fractures , 1997, Clinical orthopaedics and related research.

[3]  S. Olson.  Open fractures of the tibial shaft. , 1997, Instructional course lectures.

[4]  Turen Ch,et al.  Treatment of grade IIIB and grade IIIC open tibial fractures , 1994 .

[5]  J. Esterhai,et al.  Management of soft tissue wounds associated with type III open fractures. , 1991, The Orthopedic clinics of North America.

[6]  M. Patzakis,et al.  Choice and duration of antibiotics in open fractures. , 1991, The Orthopedic clinics of North America.

[7]  R. Gustilo,et al.  The management of open fractures. , 1990, The Journal of bone and joint surgery. American volume.

[8]  T. Moore,et al.  The use of quantitative bacterial counts in open fractures. , 1989, Clinical orthopaedics and related research.

[9]  R. Brumback,et al.  Intramedullary nailing of open fractures of the femoral shaft. , 1989, The Journal of bone and joint surgery. American volume.

[10]  M. Patzakis,et al.  Factors influencing infection rate in open fracture wounds. , 1989, Clinical orthopaedics and related research.

[11]  K. Merritt.  Factors increasing the risk of infection in patients with open fractures. , 1988, The Journal of trauma.

[12]  R. Gustilo,et al.  Classification of type III (severe) open fractures relative to treatment and results. , 1987, Orthopedics.

[13]  R. Brumback,et al.  Management of open grade III tibial fractures. , 1987, The Orthopedic clinics of North America.

[14]  C. Nelson,et al.  Microbiology for orthopaedic surgeons: selected aspects. , 1984, Clinical orthopaedics and related research.

[15]  D. N. Williams,et al.  Problems in the management of type III (severe) open fractures: a new classification of type III open fractures. , 1984, The Journal of trauma.

[16]  T. Moore,et al.  Considerations in reducing the infection rate in open tibial fractures. , 1983, Clinical orthopaedics and related research.

[17]  T. Moore,et al.  Use of antibiotics in open tibial fractures. , 1983, Clinical orthopaedics and related research.

[18]  W. Cooney,et al.  Quantitative wound cultures in upper extremity trauma. , 1982, The Journal of trauma.

[19]  W. Rittmann,et al.  Open fractures. Long-term results in 200 consecutive cases. , 1979, Clinical orthopaedics and related research.

[20]  M. Chapman,et al.  The role of early internal fixation in the management of open fractures. , 1979, Clinical orthopaedics and related research.

[21]  R. Gustilo,et al.  OTD classic article review - Gustillo RB, Anderson JT (1976) Prevention of infection in the treatment of one thousand and twenty-five open fractures of long bones: retrospective and prospective analyses , 2002, The Journal of bone and joint surgery. American volume.

[22]  J. Harvey,et al.  The role of antibiotics in the management of open fractures. , 1974, The Journal of bone and joint surgery. American volume.