Articles | Volume 8, issue 1
https://doi.org/10.5194/jbji-8-71-2023
https://doi.org/10.5194/jbji-8-71-2023
Original full-length article
 | 
14 Feb 2023
Original full-length article |  | 14 Feb 2023

Infection complicating locked intramedullary nailing of open lower-extremity fractures: incidence, associated risk factors, and lessons for improving outcome in a low-resource setting

Stephen A. Adesina, Isaac O. Amole, Akinsola I. Akinwumi, Adepeju O. Adegoke, James I. Owolabi, Imri G. Adefokun, Adewumi O. Durodola, Olufemi T. Awotunde, and Samuel U. Eyesan

Related subject area

Subject: Fracture-related infections | Topic: All topics
Candida fracture-related infection: a systematic review
Daniele De Meo, Gianluca Cera, Giancarlo Ceccarelli, Valerio Castagna, Raissa Aronica, Edoardo M. Pieracci, Pietro Persiani, and Ciro Villani
J. Bone Joint Infect., 6, 321–328, https://doi.org/10.5194/jbji-6-321-2021,https://doi.org/10.5194/jbji-6-321-2021, 2021
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Cited articles

Adesina, S. A., Eyasan, S. U., Amole, I. O., Awotunde, O. T., Akinwumi, A. I., Durodola, A. O., and Ikem, I. C.: Closed reduction and locked intramedullary nailing of diaphyseal long bone fractures without intraoperative imaging and fracture table, Int. Orthop. (SICOT), 46, 51–59, https://doi.org/10.1007/s00264-021-05091-5, 2021. 
Agarwal-Harding, K. J., von Keudell, A., Zirkle, L. G., Meara, J. G., and Dyer, G. S. M.: Understanding and addressing the global need for orthopaedic trauma care, J. Bone Joint Surg. Am., 98-A, 1844–1853, https://doi.org/10.2106/JBJS.16.00323, 2016. 
Bach, A. W. and Hansen Jr., S. T.: Plates versus external fixation in severe open tibial shaft fractures: a randomized trial, Clin. Orthop. Relat. Res., 241, 89–94, PMID: 2924483, 1989. 
Brandt, C., Sohr, D., Behnke, M., Daschner, F., Ruden, H., and Gastmeier, P.: Reduction of surgical site infection rates associated with active surveillance, Infect. Control. Hosp. Epidemiol., 27, 1347–1351, https://doi.org/10.1086/509843, 2006. 
Centers for Disease Control and Prevention: Surgical site infection (SSI) event, procedure-associated module, https://www.cdc.gov/nhsn/pdfs/pscmanual/9pscssicurrent.pdf (last access: 22 October 2022​​​​​​​), 2017. 
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Short summary
In a low-resource setting, we studied the risk factors for infection in 101 open fractures treated with the SIGN nail. We found that infection of fractures increased with fracture severity. The treatment-related factors found to have significant association with infection were also essentially the same as those known in advanced countries. We believe low-resource settings could affordably adopt management approaches of high-income countries to achieve good outcomes despite the scarce resources.