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Open fractures from watercraft injuries yielded high rates of infection, amputation
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Patients who experienced open orthopedic fractures sustained from watercrafts had a high rate of postoperative infection, nonunion and amputation, according to results published in The Journal of Orthopaedic Trauma.
After collecting demographics, watercraft type, mechanism of injury, fracture pattern, infection, organisms, union and amputation, researchers found 60% closed fractures and 40% open fractures among 146 patients with 216 fractures from watercraft, as well as 67% lower extremity fractures, 23% upper extremity fractures and 10% pelvic fractures. Results showed more fractures were associated with motorboats vs. nonpowered watercraft or personal watercrafts. Most common mechanisms of injury were collision with a fixed object followed by fall/skier mishap, propeller injury, machine failure and collision with other watercrafts.
Researchers found an overall postoperative infection rate of 9%, with a higher infection rate among aquatic injuries that underwent a staged treatment before definitive fixation vs. injuries that underwent definitive fixation during primary surgery. Primary union was achieved in 98.5% and 76% of closed and open fractures, respectively, within 6 months. Results also showed 1.5% of closed fractures underwent nonunion revision surgery vs. 8% of open fractures. Researchers noted an amputation rate of 0% in the closed fracture group vs. 16% in the open fracture group.
“Orthopedic management of open fractures occurring in an aquatic environment requires early recognition, antibiotic administration, debridement with irrigation and appropriate surgical treatment,” the authors wrote. “We recommend a heightened awareness and special attention to orthopedic aquatic injuries.” – by Casey Tingle
Disclosures: The authors report no relevant financial disclosures.
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