Your browser doesn't support javascript.
loading
Clinical Correlation of the Orthopaedic Trauma Association Open Fracture Classification With Wound Closure and Soft-Tissue Complications in Open Upper Extremity Fractures.
Putnam, Sara M; Dunahoe, Jacquelyn; Agel, Julie; Garner, Matthew R.
Afiliação
  • Putnam SM; Department of Orthopaedic Surgery, University of Nebraska Medical Center, 985640 Nebraska Medical Center, Omaha, NE.
  • Dunahoe J; Department of Orthopaedic Surgery, Harborview Medical Center, Seattle, WA; and.
  • Agel J; Department of Orthopaedic Surgery, Harborview Medical Center, Seattle, WA; and.
  • Garner MR; Department of Orthopaedic Surgery and Rehabilitation, Penn State College of Medicine, Milton S. Hershey Medical Center, 500 University Drive, Hershey, PA.
J Orthop Trauma ; 35(6): e184-e188, 2021 06 01.
Article em En | MEDLINE | ID: mdl-33079834
OBJECTIVES: To correlate domains of the Orthopaedic Trauma Association Open Fracture Classification (OTA-OFC) in open upper extremity injuries with type of definitive soft-tissue closure, complication rates, and unanticipated return to the operating room for complication. DESIGN: Retrospective review of prospectively collected data. SETTING: Level I trauma center. PATIENTS: Two hundred thirty-four consecutive open upper extremity fractures. INTERVENTION: Operative management of open upper extremity fractures. MAIN OUTCOME MEASUREMENTS: Type of definitive closure, 90-day wound complication, and wound complication necessitating return to the operating room. RESULTS: Two hundred eighty injuries were identified, and 234 had sufficient data for analysis. Eighty-four percent (196/234) of open wounds were closed primarily, 7% (16/234) required a skin graft, and 4% (9/234) required rotational or free flap. Thirteen percent (22/166) of those followed for 90 days had a wound complication, and 50% of those with complication required a return to the OR. All OTA-OFC classifications statistically significantly correlated with type of closure (P < 0.001), with skin having a high correlation (r = 0.79), muscle (r = 0.49) and contamination (r = 0.47) moderate correlations, and arterial (r = 0.32) and bone loss (r = 0.33) low correlations. OTA-OFC muscle classification was predictive of 90-day wound complication (OR 0.31, 95% confidence interval 0.07-0.21). OTA-OFC domains correlated variably with return to the OR. CONCLUSION: OTA-OFC clinically correlates with definitive wound management and 90-day wound complication in open upper extremity fractures. OTA-OFC skin classification has a high correlation with the type of definitive wound closure. OTA-OFC muscle was the only domain that correlated with 90-day wound complication and was predictive of 90-day wound complication. LEVEL OF EVIDENCE: Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.
Assuntos

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Ortopedia / Traumatismos do Braço / Fraturas Expostas Tipo de estudo: Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Humans Idioma: En Ano de publicação: 2021 Tipo de documento: Article

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Ortopedia / Traumatismos do Braço / Fraturas Expostas Tipo de estudo: Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Humans Idioma: En Ano de publicação: 2021 Tipo de documento: Article