Analysing the Management & Outcome of Open Fractures of the Femur Sustained on the Battlefield

Research Paper Title

The management and outcome of open fractures of the femur sustained on the battlefield over a ten-year period.

Background

This was a retrospective study of survivors of recent conflicts with an open fracture of the femur.

Methods

The researchers analysed the records of 48 patients (48 fractures) and assessed the outcome.

Results

The median follow up for 47 patients (98%) was 37 months (interquartile range 19 to 53); 31 (66%) achieved union; 16 (34%) had a revision procedure, two of which were transfemoral amputation (4%).

The New Injury Severity Score, the method of fixation, infection and the requirement for soft-tissue cover were not associated with a poor outcome.

The degree of bone loss was strongly associated with a poor outcome (p = 0.00204).

A total of four patients developed an infection; two with S. aureus, one with E. coli and one with A. baumannii.

Conclusions

This study shows that, compared with historical experience, outcomes after open fractures of the femur sustained on the battlefield are good, with no mortality and low rates of infection and late amputation.

The degree of bone loss is closely associated with a poor outcome.

Reference

Bennett, P.M., Sargeant, I.D., Myatt, R.W. & Penn-Barwell, J.G. (2015) The management and outcome of open fractures of the femur sustained on the battlefield over a ten-year period. The Bone & Joint Journal. 97-B(6), pp.842-846. doi: 10.1302/0301-620X.97B6.34962.

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