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

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Subject: Fracture-related infections | Topic: All topics
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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.