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Study: OTA classification better than Gustilo-Anderson for predicting results of long bone fractures
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Investigators of this retrospective study found the Orthopaedic Trauma Association open fracture classification better predicted postoperative complications and treatment outcomes for patients with open long bone fractures than the Gustilo-Anderson classification system.
Researchers retrospectively reviewed information for 512 adult patients with open long bone fractures surgically treated at a level 1 trauma center. Investigators collected data including injury, severity, treatment and outcomes. Radiographs and a prospective trauma database was used to classify fractures according to the Gustilo-Anderson and Orthopaedic Trauma Association open fracture classification (OTA-OFC) systems.
Investigators also used the Shapiro-Wilks and Kolmogrov-Smirnov tests to determine the normality of the distributions. The receiver operating characteristic curve analysis was used to determine an OTA-OFC threshold score that was linked to the risk of limb amputation. Multivariate logistic regression analysis was used to determine significant variables for treatment outcomes.
Results showed 19 patients needed limb amputations. There were no significant differences seen between patients who needed an amputation and those who did not or between patients who had an infection requiring hospitalization and soft tissue coverage and those who did not with regard to the Gustilo-Anderson classification, whereas the OTA-OFC classification showed significant differences between these groups. Investigators noted skin injury severity was the only significant risk factor for amputation.
According to researchers, patients with a OTA-OFC summative threshold score of 10 or greater had a significantly greater chance for amputation vs. those with a summative score of less than 10. ‒ by Monica Jaramillo
Disclosures: The researchers report no relevant financial disclosures.
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