Does the OTA Open Fracture Classification Align With the Gustilo-Anderson Classification? A Study of 2215 Open Fractures.
J Orthop Trauma
; 38(2): 65-71, 2024 Feb 01.
Article
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| MEDLINE
| ID: mdl-38031292
ABSTRACT
OBJECTIVES:
To characterize the Orthopaedic Trauma Association Open Fracture Classification (OTA-OFC) and Gustilo-Anderson classification of open extremity fractures and determine if there is meaningful alignment between these grading systems.DESIGN:
Retrospective case series.SETTING:
Level I academic trauma center. PATIENT SELECTION CRITERIA Adult patients with at least 1 operatively treated open extremity fracture and surgeon-assigned OTA-OFC and Gustilo-Anderson classification. OUTCOME MEASURES AND COMPARISONS Frequency, distribution, and association measures of OTA-OFC category scores and Gustilo-Anderson classification types.RESULTS:
Two thousand twenty-seven patients (mean age, 43.1 ± 17.5 years) with 2215 fractures were included. Gustilo-Anderson type I or II fractures (n = 961; 43%) most frequently had the least severe scores for all OTA-OFC categories. Type IIIA fractures (n = 978; 44%) were most often assigned intermediate scores for OTA-OFC Bone Loss (n = 564; 58%). Type IIIB fractures (n = 204, 9%) were most often assigned intermediate OTA-OFC Skin scores (n = 120; 59%). Type IIIC fractures (n = 72; 3%) were most often assigned the most severe OTA-OFC Arterial score (n = 60; 83%). In the multivariable model, OTA-OFC Contamination scores showed little association (ß = 0.05; 95% confidence interval [CI], 0.01-0.09) with Gustilo-Anderson classification severity. Conversely, higher OTA-OFC Arterial (ß = 0.50; 95% CI 0.44-0.56) and Skin (ß = 0.46; 95% CI, 0.40-0.51) scores were strongly associated with more severe Gustilo-Anderson classifications.CONCLUSIONS:
OTA-OFC Contamination scores were weakly associated with Gustilo-Anderson classification severity for open fractures. The study findings suggest that the current Gustilo-Anderson classification does not adequately account for injury contamination, a known predictor of infection. LEVEL OF EVIDENCE Diagnostic Level IV. See Instructions for Authors for a complete description of levels of evidence.
Texto completo:
1
Colección:
01-internacional
Banco de datos:
MEDLINE
Asunto principal:
Ortopedia
/
Fracturas de la Tibia
/
Fracturas Abiertas
Límite:
Adult
/
Humans
/
Middle aged
Idioma:
En
Revista:
J Orthop Trauma
Asunto de la revista:
ORTOPEDIA
/
TRAUMATOLOGIA
Año:
2024
Tipo del documento:
Article
País de afiliación:
Moldova