Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2022 Dec;142(12):3599-3603.
doi: 10.1007/s00402-021-03954-5. Epub 2021 May 16.

Evaluation of the orthopaedic trauma association open fracture classification (OTA-OFC) as an outcome prediction tool in open tibial shaft fractures

Matthew R Garner  1 , Stephen J Warner  2 , Jacob A Heiner  2 , Yesul T Kim  3 , Julie Agel  4
Affiliations

Evaluation of the orthopaedic trauma association open fracture classification (OTA-OFC) as an outcome prediction tool in open tibial shaft fractures

Matthew R Garner et al. Arch Orthop Trauma Surg. 2022 Dec.

Abstract

Introduction: It was the goal of this study to determine if the Orthopaedic Trauma Association Open Fracture Classification (OTA-OFC) correlates with complication rates and to determine if it can be used as a predictive tool in the treatment of open tibial shaft fractures.

Materials and methods: Retrospective review from two high-volume level 1 trauma centers of open tibial shaft fractures over a 5 year period. Variables of interest included OTA-OFC, type of wound closure, 90-day wound complication, unplanned re-operation, non-union, and amputation.

Results: 501 consecutive open tibial shaft fractures. 57.3% (n = 287) were closed primarily; local soft tissue advancement/rotational flap was used in 9.6% (n = 48); free soft tissue transfer used in 22.8% (n = 114); 8.6% (n = 43) required amputation. Of those followed for 90 days (n = 419), 45 (9.0%) had a wound complication, of which 40 (8%) required an unplanned reoperation. 40 (8.0%) patients went on to a documented non-union. All OTA-OFC classification groups significantly correlated with type of definitive closure (r = 0.18-0.81, p < 0.05) with OTA-OFC skin showing the strongest correlation (r = 0.81). OTA-OFC bone loss weakly correlated with wound complication (r = 0.12, p = 0.02) and no OTA-OFC classification correlated with the need for an unplanned secondary procedure. OTA-OFC skin, muscle and arterial all weakly correlated with non-union (r = 0.18-0.25, p < 0.05). OTA-OFC muscle was predictive of non-union (OR = OR = 2.2, 95% CI = 1.2-4.1) and amputation (OR 9.3, 95% CI = 3.7-23.7). OTA-OFC arterial was also predictive of amputation (OR 4.8, 95% CI = 2.5-9.3).

Conclusions: The OTA-OFC correlates variably with the type of definitive closure, the development of a 90-day wound complication, and the occurrence of a non-union. Importantly, OTA-OFC muscle classification is predictive of non-union while both OTA-OFC muscle and arterial were predictive of amputation.

Keywords: 90-day wound complication; Open fracture classification; Open tibia fracture.

PubMed Disclaimer

Similar articles

See all similar articles

Cited by

References

    1. Bone LB, Kassman S, Stegemann P, France J (1994) Prospective study of union rate of open tibial fractures treated with locked, unreamed intramedullary nails. J Orthop Trauma 8(1):45–49. https://doi.org/10.1097/00005131-199402000-00010 - DOI - PubMed
    1. Khatod M, Botte MJ, Hoyt DB, Meyer RS, Smith JM, Akeson WH (2003) Outcomes in open tibia fractures: relationship between delay in treatment and infection. J Trauma 55(5):949–954. https://doi.org/10.1097/01.TA.0000092685.80435.63 - DOI - PubMed
    1. Harley BJ, Beaupre LA, Jones CA, Dulai SK, Weber DW (2002) The effect of time to definitive treatment on the rate of nonunion and infection in open fractures. J Orthop Trauma 16(7):484–490. https://doi.org/10.1097/00005131-200208000-00006 - DOI - PubMed
    1. Fong K, Truong V, Foote CJ, Petrisor B, Williams D, Ristevski B, Sprague S, Bhandari M (2013) Predictors of nonunion and reoperation in patients with fractures of the tibia: an observational study. BMC Musculoskelet Disord 14:103. https://doi.org/10.1186/1471-2474-14-103 - DOI - PubMed - PMC
    1. Enninghorst N, McDougall D, Hunt JJ, Balogh ZJ (2011) Open tibia fractures: timely debridement leaves injury severity as the only determinant of poor outcome. J Trauma 70(2):352–356. https://doi.org/10.1097/TA.0b013e31820b4285 (discussion 6–7) - DOI - PubMed

LinkOut - more resources