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

Eur J Trauma Emerg Surg. 2017 Oct;43(5):651-656. doi: 10.1007/s00068-016-0725-y. Epub 2016 Sep 22.

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.

Keywords: Infection; Orthopedics; Tibia fractures.

Publication types

  • Evaluation Study

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Databases, Factual
  • Female
  • Fracture Fixation, Intramedullary
  • Fracture Healing
  • Fractures, Ununited / diagnostic imaging
  • Fractures, Ununited / pathology
  • Fractures, Ununited / surgery*
  • Humans
  • Incidence
  • Injury Severity Score*
  • Male
  • Middle Aged
  • Postoperative Complications / epidemiology
  • Predictive Value of Tests
  • Retrospective Studies
  • Risk Factors
  • Surgical Wound Infection / epidemiology
  • Tibial Fractures / diagnostic imaging
  • Tibial Fractures / pathology
  • Tibial Fractures / surgery*
  • United States / epidemiology
  • Young Adult