Sage Journals: Discover world-class research

Abstract

Avoiding the development of deep bone infection following open long bone fractures remains the aim when managing such injuries. Standards of care have been developed in the UK, and adopted by others, that are effective at avoiding bone infection in these cases. However, despite these strict standards, cases of infection do develop and these must be dealt with aggressively and decisively.

Keywords

Bone infection open fractures orthoplastic surgery

Get full access to this article

View all access options for this article.

References

Abulfotooh

. Osteomyelitis: historical review. Pan Arab J Orth Trauma 2003; 7: 95–109.

Kremers

Nwojo

Ransom

et al.

Trends in the epidemiology of osteomyelitis: a population-based study, 1969–2009. JBJS-A 2015; 97: 837–845.

Wright

Khan

. Serum complement-reactive protein (CRP) trends following local and free-tissue reconstruction for traumatic injuries or chronic wounds of the lower limb. JPRAS 2010; 63: 1519–1522.

Craigen

MAC

Watters

Hackett

. Changing epidemiology of osteomyelitis in children. JBJS-B 1992; 74: 541–545.

Y-Q

Zhu

Y-L

Fan

X-Y

et al.

Implant-related infection in the tibia: surgical revision strategy with vancomycin cement. Sci World J 2014; 201: 124864–124864.

Zimmerli

Waldvogel

Vaudaux

et al.

Pathogenesis of foreign body infection: description and characteristics of an animal model. J Infect Dis 1982; 146: 487–497.

Cierny

. Surgical treatment of osteomyelitis. Plast Reconstr Surg 2011; 127(Suppl 1): S190–S204.

Stewart

Costerton

. Antibiotic resistance of bacteria in biofilms. Lancet 2001; 358: 135–138.

Gristina

. Biometerial-centered infection: microbial adhesion versus tissue integration. Science 1987; 237: 1588–1595.

10.

Gustilo

Merkow

Templeton

. The management of open fractures. J Bone Joint Surg Am 1990; 72: 299–304.

11.

Chummun

Healey

Wigglesworth

et al.

Does vascular injury affect the outcome of open tibial fractures?

Plast Reconstr Surg 2013; 131: 303–309.

12.

Morris

Unger

Archer

et al.

Risk factors of infection after ORIF of bicondylar tibial plateau fractures. J Orthop Trauma 2013; 27: e196–e200.

13.

Arnez

Khan

Tyler

. Classification of soft-tissue degloving in limb trauma. JPRAS 2010; 63: 1865–1869.

14.

Kanakaris

Gianoudis

. The health economics of the treatment of treatment of long bone non-union. Injury 2007; 38s: S77–S84.

15.

Nanchahal

Nayagam

Khan

et al.

Standards for the management of open fractures of the lower limb, London: RSM Press, 2009.

16.

Patzakis

Harvey

Ivler

. The role of antibiotics in the management of open fractures. JBJS-A 1974; 56: 532–541.

17.

Patzakis

Bain

Lee

et al.

Prospective, Randomized, double-blind study comparing single-agent antibiotic therapy, ciprofloxacin, to combination antibiotic therapy in open fracture wounds. JOT 2000; 14: 529–533.

18.

Bhandari

Adili

Schemitsch

. The efficacy of low-pressure lavage with different irrigating solutions to remove adherent bacteria from bone. JBJS-Am 2001; 83: 412–419.

19.

The FLOW investigators. A trial of wound irrigation in the initial management of open fracture wounds. N Engl J Med 2015; 373: 2629–2641.

20.

Khan

Kelly

Pleat

et al.

Orthoplastics: an integral evolution within comprehensive trauma care. Injury 2011; 42: 969–971.

21.

Khan

Boriani

Baldini

. Orthoplastics: an evolving concept for integrated surgical care of complex limb trauma and abnormality. PRS 2013; 131: 313–314.

22.

Naique

Pearse

Nanchahal

. Management of severe open tibial fractures: the need for combined orthopaedic and plastic surgical treatment in specialist centres. JBJS-Br 2006; 88: 351–357.

23.

Godina

. Early microsurgical reconstruction of complex trauma of the extremities. Plast Reconstr Surg 1986; 78: 285–292.

24.

Starnes-Roubaud

Peric

Chowdry

et al.

Microsurgical lower extremity reconstruction in the subacute period: a safe alternative. PRS-GO 2015; 10: e449–e449.

25.

Saddawi-Konefka

Hyungiin

Chung

. A systematic review of outcomes and complications of reconstruction and amputation for type IIIB and IIIC fractures of the tibia. Plast Reconstr Surg 2008; 122: 1796–1805.

26.

Gopal

Majumbar

Batchelor

AGB

et al.

Fix and flap: the radical orthopaedic and plastic treatment of severe open fractures of the tibia. JBJS-Br 2000; 82(7): 959–966.

27.

Ninkovic

Schoeller

Benedetto

. Emergency free flap in complex injuries of the lower extremity. Scan J Plast Reconstr Surg 1996; 30: 37–47.

28.

Matthews

Ward

Chapman

et al.

Single-stage orthoplastic reconstruction of Gustilo-Anderson Grade III open tibial fractures greatly reduces infection rates. Injury 2015; 46: 2263–2266.

29.

NICE. Fractures (complex): assessment and management, www.nice.org.uk/guidance/ng37 (accessed 12 June 2017).

30.

Ikpeme

Ngim

Ikpeme

. Diagnosis and treatment of pyogenic bone infections. Afr Health Sci 2010; 10: 82–88.

31.

Masqualet

. The reconstruction of wide diaphyseal bone defect by foreign body induced membrane and bone grafts. e-memoires de l’Acadamie Nationale de Chirurgie 2008; 7: 34–38.

32.

Pelissier

Martin

. Behaviour of cancellous bone graft placed in induced membranes. BJPS 2002; 55: 598–598–598–598.

33.

Pelissier

Masqualet

Bareille

et al.

Induced membranes secrete growth factors including vascular and osteoinductive factors and could stimulate bone regeneration. J Orthop Res 2004; 22: 73–79.

34.

Yin

Zhang

et al.

The treatment of infected tibial non-union by bone transport using the Ilizarov external fixator and a systematic review of infected tibial nonunions treated by Ilizarov methods. Acta Orthop Belg 2014; 80: 426–435.

35.

Sun

Zhang

Jin

et al.

Free vascularised fibular grafting in the treatment of large skeletal; defects due to osteomyelitis. Int Orthop 2010; 34: 425–430.

36.

Lexer

. Free transplantation. Ann Surg 1914; 60: 166–194.

37.

Urbaniak

Black

. Cadaveric elbow allografts. A six-year experience. Clin Orthop Relat Res 1985; 197: 131–140.

An orthoplastic approach to bone infection after trauma

Abstract

Keywords

Get full access to this article

References