Infection Rates Amongst Patients Undergoing Treatment of Long Bone Fractures at a Tertiary Care Centre: A Comparative Study

  • Indranil Dutt Associate Professor, Department of Orthopaedics, Mata Gujri Memorial Medical College, Kishanganj, Bihar, India.
Keywords: Debridement, Comparative, Immobilization, Tetanus.


Background: Prevention of sepsis of wound is the chief and prime objective in the management of fractures. Ideal treatment sequence of open fractures include tetanus prophylaxis, immobilization, antibiotic prophylaxis, wound debridement with fixation of fracture. Most of the infections usually develop during first month after surgery; a vast majority develop during first seven days. The aim of present study is to establish the incidence of infection in fractures treated by open reduction. Methods: The present comparative study was conducted in the Department of Orthopaedics, Mata Gujri Memorial Medical College, Kishanganj, Bihar (India) during a period of 1 year. Patients were divided into two groups i.e. Group I (individuals undergoing treatment within 8 hours after trauma) and Group II (individuals undergoing treatment after 8 hours of trauma). Following data was collected from the patient or from medical records i.e. time of accident, mechanism of injury, time elapsed between trauma and emergency surgery and length of hospital stay was also noted. The exact anatomical location of fracture and type of surgical treatment performed was also noted. The data was organised in a tabulated form and analyzed using SPSS software. Results: Total of 104 patients reported to the hospital during the study. 75% reported with road traffic accident, making it the leading cause of trauma. 10% reported with a fall from a level. There were 51 patients (49%) with fractured tibia making it the most common fracture of long bone. 69.2% patients (n=72) underwent external fixation. Cast was applied in 14.4 %( n=15). In patients treated within 8 hours of trauma, only 8 patients (12.7%) of total 63 patients suffered from infection. Conclusions: The delay between trauma and surgery can affect infection rate amongst fracture of long bones.


Download data is not yet available.


1. Zalavras CG, Patzakis MJ. Open fractures: evaluation and management. J Am Acad Orthop Surg. 2003;11(3):212-9.
2. COPELAND, C. X., JR., and ENNEKING, W. F.: Incidence of Osteomyelitis in Compound Fractures. Am. Surg. , 31: 156-158, 1965.
3. DALAND, E. M.: The Management of Two Hundred and Thirty-six Compound Fractures Treated at the Massachusetts General Hospital. New England J. Med. , 210: 983-995, 1934.
4. Davis, A. G.: Primary Closure of Compound-Fracture Wounds, With Immediate Internal Fixation, Immediate Skin Graft, and Compression Dressings, J. Bone and Joint Surg. , 30-A: 405-415, April 1948.
5. Lerner, B.H. Searching for Semmelweis. Lancet. 2014; 383: 210-201.
6. Gustillo, R.B. and Anderson, J.T. Prevention of infection in the treatment of one thousand and twenty five open fractures of long bones: retrospective and prospective analyses. J Bone Joint Surg Am. 1976; 58: 453-458.
7. Carmont MR. The Advanced Trauma Life Support course: a history of its development and review of related literature. Postgrad Med J. 2005;81(952):87-91.
8. Stevens, D.B. Postoperative orthopaedic infections. A study of etiological mechanisms. J Bone Joint Surg Am. 1964; 46: 96-102.
9. Morris, B.J., Unger, R.Z., Archer, K.R., et al. Risk factors of infection after ORIF of bicondylar tibial plateau fractures. J Orthop Trauma. 2013; 27: E196-200.
10. Ruffolo, M.R., Gettys, F.K., Montijo, H.E., et al. Complications of high-energy bicondylar tibial plateau fractures treated with dual plating through 2 incisions. J Orthop Trauma. 2015; 29: 85-90.
11. Jacob E, Erpelding JM, Murphy KP. A retrospective analysis of open fractures sustained by U.S. military personnel during Operation Just Cause. Mil Med. 1992;157(10):552-6.
12. Kreder HJ, Armstrong P. A review of open tibia fractures in children. J Pediatr Orthop. 1995;15(4):482-8.
13. Kindsfater K, Jonassen EA. Osteomyelitis in grade II and III open tibia fractures with late debridement. J Orthop Trauma. 1995;9(2):121-7.
14. Müller SS, Sadenberg T, Pereira GJC, Sadatsune T, Kimura EE, Novelli Filho JLV. Estudo epidemiológico, clínico e microbiológico prospectivo de pacientes portadores de fraturas expostas atendidos em hospital universitário. Acta Ortop Bras. 2003;11(3):158-69.
15. Lack, W.D., Karunakar, M.A., Angerame, M.R., et al. Type 111 Open tibia fractures: immediate antibiotic prophylaxis minimizes infection. J Orthop Trauma. 2015; 29: 1-6.
16. Spencer J, Smith A, Woods D. The effect of time delay on infection in open long-bone fractures: a 5-year prospective audit from a district general hospital. Ann R Coll Surg Engl. 2004;86(2):108-12.
How to Cite
Dutt I. Infection Rates Amongst Patients Undergoing Treatment of Long Bone Fractures at a Tertiary Care Centre: A Comparative Study. IABCR [Internet]. 18Mar.2017 [cited 21Jul.2019];3(1):22-4. Available from: