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Open Tibial Shaft Fractures: Treatment Patterns in Latin America

Albright, Patrick D ; MacKechnie, Madeline C ; Roberts, Heather J ; Shearer, David W ; Padilla Rojas, Luis G ; Segovia, Julio ; Quintero, Jose Eduardo ; Amadei, Rafael ; Baldy dos Reis, Fernando ; Miclau, Theodore

Journal of bone and joint surgery. American volume, 2020-11, Vol.102 (22), p.e126-e126 [Periódico revisado por pares]

United States: Copyright by The Journal of Bone and Joint Surgery, Incorporated

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Título:
Open Tibial Shaft Fractures: Treatment Patterns in Latin America
Autor: Albright, Patrick D ; MacKechnie, Madeline C ; Roberts, Heather J ; Shearer, David W ; Padilla Rojas, Luis G ; Segovia, Julio ; Quintero, Jose Eduardo ; Amadei, Rafael ; Baldy dos Reis, Fernando ; Miclau, Theodore
Assuntos: Antibiotic Prophylaxis - methods ; Antibiotic Prophylaxis - statistics & numerical data ; Debridement - methods ; Debridement - statistics & numerical data ; Female ; Fracture Fixation - methods ; Fracture Fixation - statistics & numerical data ; Fractures, Open - pathology ; Fractures, Open - surgery ; Fractures, Open - therapy ; Humans ; Latin America ; Male ; Practice Patterns, Physicians' - statistics & numerical data ; Surveys and Questionnaires ; Therapeutic Irrigation - methods ; Therapeutic Irrigation - statistics & numerical data ; Tibia - pathology ; Tibia - surgery ; Tibial Fractures - pathology ; Tibial Fractures - surgery ; Tibial Fractures - therapy
É parte de: Journal of bone and joint surgery. American volume, 2020-11, Vol.102 (22), p.e126-e126
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SourceType-Scholarly Journals-1
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Descrição: BACKGROUND:Open tibial shaft fractures are an important source of disability in Latin America. High-income countries (HICs) worldwide have established standardized treatment protocols for open tibial fractures, but less is known about their treatment in middle-income countries (MICs) in Latin America. This survey of Latin American orthopaedic surgeons characterizes open tibial fracture treatment patterns. METHODS:Orthopaedic surgeons from 20 national orthopaedic societies throughout Latin America completed an online survey assessing their treatment of open tibial fractures. Demographic information was collected. Treatment patterns were queried according to 2 groupings of Gustilo-Anderson (GA) fracture typestreatment of type-I and type-II fractures (GA-I/II) and treatment of type-III fractures (GA-III). Treatment patterns were evaluated across 4 domainsantibiotic prophylaxis, irrigation and debridement, fracture stabilization, and wound management. Summary statistics were reported; analysis was performed using the Fisher exact test (p < 0.05). RESULTS:There were 616 survey participants from 20 Latin American countries (4 HICs and 16 MICs). Initial external fixation followed by staged internal fixation was preferred for GA-I/II (51.0%) and GA-III fractures (86.0%). Nearly one-third (31.5%) of GA-IIIB fractures did not receive a soft-tissue coverage procedure. Stratifying by country socioeconomic status, surgeons in MICs more commonly utilized delayed internal fixation for GA-I/II (53.3% versus 22.0%, p < 0.001) and GA-III fractures (94.0% versus 80.4%, p = 0.002). Surgeons in MICs more commonly used primary closure for GA-I/II (88.9% versus 62.8%, p < 0.001) and GA-III fractures (32.6% versus 9.8%, p < 0.001). CONCLUSIONS:This survey reports Latin American orthopaedic surgeons’ treatment patterns for open tibial shaft fractures. Surgeons in MICs reported higher delayed internal fixation use for all fracture types, while surgeons in HICs more routinely avoid primary closure. Soft-tissue coverage procedures are not performed in nearly one-third of GA-IIIB fractures because of a lack of operative personnel and training.
Editor: United States: Copyright by The Journal of Bone and Joint Surgery, Incorporated
Idioma: Inglês

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Open Tibial Shaft Fractures: Treatment Patterns in Latin America

Albright, Patrick D ; MacKechnie, Madeline C ; Roberts, Heather J ; Shearer, David W ; Padilla Rojas, Luis G ; Segovia, Julio ; Quintero, Jose Eduardo ; Amadei, Rafael ; Baldy dos Reis, Fernando ; Miclau, Theodore

United States: Copyright by The Journal of Bone and Joint Surgery, Incorporated

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