The Treatment of Infected Fracture of Long Bones

Jeong, Hak Yeong; Yang, Seung Wook; Shin, Young Cheol; Shim, Jae Woong

Abstract

The increase in incidence and severity of open injury to bone and surrounding soft tisseues from vehicular and industrial accidents, and the aggressive surgical approach of open reduction and internal fixation of closed fractures contribute to a definite rise in acute wound infection in fracture management. The main objectives are twofold in the treatment of infected fractures, the first to diagnose infection early and the second to treat it effectively and to prevent it from spreading into bone. To solve these problems, we used some principles of treatment, those are meticulous debridement of infected tissue, management of soft tissue and bony defect and maintenance of fracture stability. From Jan. 1988 to Dec. 1993, we treated 23 infected fractures of long bone and the result were as follows. 1. The infected fractures were femur in 9 and tibia in 14 cases. 2. There were 14 open fractures and 9 closed fractures. 3. In closed fracture, the first infection sign was developed average 7.8 days after open reduction, and average 9 days after trauma in open fracture. 4. The most common causative organism was staphylococcus aureus. 5. Infection was controlled from 3 months to a year and 8 months. 6. The number of soft tissue and bone debridement was one to four times. 7. Bony union was achieved from 6 months to 2 years in tibia and 6 months to 2 years and 1 month in femur.