Skip to main content

Infections Associated with Severe Open Tibial Fractures

  • Chapter
  • First Online:
Culture Negative Orthopedic Biofilm Infections

Part of the book series: Springer Series on Biofilms ((BIOFILMS,volume 7))

  • 592 Accesses

Abstract

Severe open tibial fractures are frequently complicated by infection. There is some data that external fixation of these fractures results in fewer and less serious infections than internal fixation. However, there is insufficient data in this regard to justify such a recommendation at this juncture. Therefore, there is a pressing need for a multi-center, prospective, randomized clinical trial to ascertain if there are statistically significant benefits of one fixation type versus the other for tibial fracture. Towards that end we have developed the FixIt Trial which aims to enroll 300 patients with type IIIB or “severe” type IIIA tibial fractures from 23 major civilian and military trauma centers for randomization of treatment and clinical follow-up for one year.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 129.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 169.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 169.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  • Bach AW, Hansen ST (1989) Plate versus external fixation in severe open tibial shaft fractures. Clin Orthop Relat Res 241:89–94

    PubMed  Google Scholar 

  • Bosse MJ, MacKenzie EJ, Kellam JF et al (2002) An analysis of outcomes of reconstruction or amputation of leg-threatening injuries. N Engl J Med 347:1924–1931

    Article  PubMed  Google Scholar 

  • Burns TC, Stinner DJ, Possley DR et al (2010) Does the zone of injury in combat-related Type III open tibia fractures preclude the use of local soft tissue coverage? J Orthop Trauma 24:697–703

    Article  PubMed  Google Scholar 

  • D’Alleyrand JG, Dancy L, Castillo R, et al (2010) Is time to flap coverage an independent predictor of flap complication. In: Presented at the Orthopaedic Trauma Association 26th annual meeting, October 16, Baltimore, MD. http://www.hwbf.org/ota/am/ota10/otapa/OTA100671.htm. Accessed July 2011

  • Doucet JJ, Galameau MR, Potenza BM et al (2011) Combat versus civilian open tibia fractures: the effect of blast mechanism on limb salvage. J Trauma 70:1241–1247

    Article  PubMed  Google Scholar 

  • Giannoudis PV, Papkostidis C, Roberts C (2006) A review of the management of open fractures of the tibia and femur. J Bone Joint Surg Br 88:281–289

    Article  PubMed  CAS  Google Scholar 

  • Gottenbos B, van der Mei HC, Busscher HJ (2000) Initial adhesion and surface growth of Staphylococcus epidermidis and Pseudomonas aeruginosa on biomedical polymers. J Biomed Mater Res 50:208–214

    Article  PubMed  CAS  Google Scholar 

  • Gustilo RB, Mendoza RM, Williams DN (1984) Problems in the management of Type III (severe) open fractures: a new classification of Type III open fractures. J Trauma 24:742–746

    Article  PubMed  CAS  Google Scholar 

  • Hutson JJ, Dayicioglu D, Oeltjen JC et al (2010) The treatment of Gustilo grade IIIB tibia fractures with application of antibiotic spacer, flap, and sequential distraction osteogenesis. Ann Plast Surg 64:541–552

    PubMed  CAS  Google Scholar 

  • Keeling JJ, Gwinn DE, Tintle SM et al (2008) Short-term outcomes of severe open wartime tibial fractures treated with ring external fixation. J Bone Joint Surg Am 90:2643–2651

    Article  PubMed  Google Scholar 

  • Lacap AP, Frisch HM (2007) Intramedullary nailing following external fixation in tibial shaft fractures sustained in Operations Enduring and Iraqi Freedom. In: Poster presented at the Annual Meeting of the Orthopaedic Trauma Association, Oct 17–20, Boston, MA

    Google Scholar 

  • Lerner A, Fodor L, Soudry M (2006) Is staged external fixation a valuable strategy for war injuries to the limbs? Clin Orthop Relat Res 448:217–224

    Article  PubMed  Google Scholar 

  • Stall A, Gupta R, O’Toole RV, Zadnik M (2010) Does perioperative hyperoxygenation decrease surgical site infection in orthopaedic trauma patients? Podium presentation at American Academy of Orthopaedic Surgeons, March, New Orleans, LA

    Google Scholar 

  • van der Borden AJ, van der Werf H, van der Mei HC, Busscher HJ (2004) Electric current-induced detachment of Staphylococcus epidermidis biofilms from surgical stainless steel. Appl Environ Microbiol 70:6871–6874

    Article  PubMed  Google Scholar 

  • Zeliko B, Lovrć Z, Amć E et al (2006) War injuries of the extremities: twelve-year follow-up data. Mil Med 171:55–57

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Robert V. O’Toole .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2012 Springer-Verlag Berlin Heidelberg

About this chapter

Cite this chapter

O’Toole, R.V. (2012). Infections Associated with Severe Open Tibial Fractures. In: Ehrlich, G., DeMeo, P., Costerton, J., Winkler, H. (eds) Culture Negative Orthopedic Biofilm Infections. Springer Series on Biofilms, vol 7. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-29554-6_7

Download citation

Publish with us

Policies and ethics