HOW DOES DELAY IN MANAGEMENT OF OPEN TIBIAL FRACTURES AFFECT OUTCOME?
Harish K. Shanker; CanavanB ; WongJ ; and McGeeH Londonderry. Open tibial fractures have traditionally been treated as surgical emergencies. However, the “golden eight hour rule” for emergent treatment of these injuries is based more on historic principles and in-vitro data. A substantial number of open tibial fractures referred to our hospital from the peripheral referral units have transport times in excess of eight hours. These circumstances provide the source for the present study of the effect of delay in initial treatment on the final outcome in terms of infection, delayed union, non-union, malalignment and failure of fixation. Between January 1998 and June 2001, 53 open tibial fractures were treated at our institution. The fractures were classified using the Gustilo classification. All patient had a minimum of one year s follow-up. Patients were categorized into 4 groups based on the time delay from injury to surgery, namely those treated within 6 hours of injury, 6 to 12 hours,
