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Factors associated with the outcome of open tibial fractures

Background: Although open tibial fractures are common in Malaysia, the outcomes for these patients have not been evaluated in the literature. This retrospective study was conducted to examine the factors associated with infection and non-union in open tibial fractures managed at Hospital Tengku Ampu...

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Main Authors: Mohd Yusof, Nazri, Khalid, Kamarul Ariffin, Zulkifly, Ahmad Hafiz, Zakaria@Mohamad, Zamzuri, Mohammad Amin, Mohammad Azril, Awang, Mohd Shukrimi, Che Ahmad, Aminudin, Akter, Sheikh Farid Uddin
Format: Article
Language:English
Published: Universiti Sains Malaysia 2013
Subjects:
RD701 Orthopedics
Online Access:http://irep.iium.edu.my/32447/1/open_tibial_fracture.pdf
http://irep.iium.edu.my/32447/
http://ernd.usm.my/journal/journal/mjms-20-5-047.pdf
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spelling my.iium.irep.324472015-03-11T06:21:14Z http://irep.iium.edu.my/32447/ Factors associated with the outcome of open tibial fractures Mohd Yusof, Nazri Khalid, Kamarul Ariffin Zulkifly, Ahmad Hafiz Zakaria@Mohamad, Zamzuri Mohammad Amin, Mohammad Azril Awang, Mohd Shukrimi Che Ahmad, Aminudin Akter, Sheikh Farid Uddin RD701 Orthopedics Background: Although open tibial fractures are common in Malaysia, the outcomes for these patients have not been evaluated in the literature. This retrospective study was conducted to examine the factors associated with infection and non-union in open tibial fractures managed at Hospital Tengku Ampuan Afzan (HTAA), Kuantan, in 2009. Methods: From 1 January until 31 December 2009, the Department of Orthopaedics of HTAA managed 58 patients with open tibial fracture who had a minimum of a one year follow-up period. The median age was 24.5 years (range: 4 to 72 years). The open tibial fractures were graded using the Gustilo open fracture classification as follows: 4 grade I, 21 grade II, 24 grade IIIA and 9 grade IIIB. All open fractures were subjected to a standard treatment protocol at HTAA, which includes the use of prophylactic antibiotics, emergency debridement, fracture stabilisation, wound coverage, and bone reconstruction when required. The mean time from injury to the initial debridement was 29.7 hours (range: 13 to 216 hours). Results: Seventeen (29%) cases were complicated by infection, and 10 patients (17%) developed non-union. The grade of the open fracture was significantly associated with infection, and age and the time interval between the injury and the initial wound debridement were significantly associated with non-union. Conclusions: The high rates of infection and non-union, particularly in severe open fractures, indicate that there is a need to improve the management of open tibial fractures treated at HTAA. The time to initial debridement is an important factor that can be readily amended to improve the outcome. Further studies with larger sample sizes are likely needed to replicate and confirm our findings. Keywords: assessment, case management, fractures, open, patient outcome, tibia Universiti Sains Malaysia 2013-10 Article REM application/pdf en http://irep.iium.edu.my/32447/1/open_tibial_fracture.pdf Mohd Yusof, Nazri and Khalid, Kamarul Ariffin and Zulkifly, Ahmad Hafiz and Zakaria@Mohamad, Zamzuri and Mohammad Amin, Mohammad Azril and Awang, Mohd Shukrimi and Che Ahmad, Aminudin and Akter, Sheikh Farid Uddin (2013) Factors associated with the outcome of open tibial fractures. Malaysian Journal of Medical Sciences , 20 (5). pp. 47-53. ISSN 1394-195X http://ernd.usm.my/journal/journal/mjms-20-5-047.pdf
institution Universiti Islam Antarabangsa Malaysia
building IIUM Library
collection Institutional Repository
continent Asia
country Malaysia
content_provider International Islamic University Malaysia
content_source IIUM Repository (IREP)
url_provider http://irep.iium.edu.my/
language English
topic RD701 Orthopedics
spellingShingle RD701 Orthopedics
Mohd Yusof, Nazri
Khalid, Kamarul Ariffin
Zulkifly, Ahmad Hafiz
Zakaria@Mohamad, Zamzuri
Mohammad Amin, Mohammad Azril
Awang, Mohd Shukrimi
Che Ahmad, Aminudin
Akter, Sheikh Farid Uddin
Factors associated with the outcome of open tibial fractures
description Background: Although open tibial fractures are common in Malaysia, the outcomes for these patients have not been evaluated in the literature. This retrospective study was conducted to examine the factors associated with infection and non-union in open tibial fractures managed at Hospital Tengku Ampuan Afzan (HTAA), Kuantan, in 2009. Methods: From 1 January until 31 December 2009, the Department of Orthopaedics of HTAA managed 58 patients with open tibial fracture who had a minimum of a one year follow-up period. The median age was 24.5 years (range: 4 to 72 years). The open tibial fractures were graded using the Gustilo open fracture classification as follows: 4 grade I, 21 grade II, 24 grade IIIA and 9 grade IIIB. All open fractures were subjected to a standard treatment protocol at HTAA, which includes the use of prophylactic antibiotics, emergency debridement, fracture stabilisation, wound coverage, and bone reconstruction when required. The mean time from injury to the initial debridement was 29.7 hours (range: 13 to 216 hours). Results: Seventeen (29%) cases were complicated by infection, and 10 patients (17%) developed non-union. The grade of the open fracture was significantly associated with infection, and age and the time interval between the injury and the initial wound debridement were significantly associated with non-union. Conclusions: The high rates of infection and non-union, particularly in severe open fractures, indicate that there is a need to improve the management of open tibial fractures treated at HTAA. The time to initial debridement is an important factor that can be readily amended to improve the outcome. Further studies with larger sample sizes are likely needed to replicate and confirm our findings. Keywords: assessment, case management, fractures, open, patient outcome, tibia
format Article
author Mohd Yusof, Nazri
Khalid, Kamarul Ariffin
Zulkifly, Ahmad Hafiz
Zakaria@Mohamad, Zamzuri
Mohammad Amin, Mohammad Azril
Awang, Mohd Shukrimi
Che Ahmad, Aminudin
Akter, Sheikh Farid Uddin
author_facet Mohd Yusof, Nazri
Khalid, Kamarul Ariffin
Zulkifly, Ahmad Hafiz
Zakaria@Mohamad, Zamzuri
Mohammad Amin, Mohammad Azril
Awang, Mohd Shukrimi
Che Ahmad, Aminudin
Akter, Sheikh Farid Uddin
author_sort Mohd Yusof, Nazri
title Factors associated with the outcome of open tibial fractures
title_short Factors associated with the outcome of open tibial fractures
title_full Factors associated with the outcome of open tibial fractures
title_fullStr Factors associated with the outcome of open tibial fractures
title_full_unstemmed Factors associated with the outcome of open tibial fractures
title_sort factors associated with the outcome of open tibial fractures
publisher Universiti Sains Malaysia
publishDate 2013
url http://irep.iium.edu.my/32447/1/open_tibial_fracture.pdf
http://irep.iium.edu.my/32447/
http://ernd.usm.my/journal/journal/mjms-20-5-047.pdf
_version_ 1643610225103601664
score 13.211869

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