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Citation
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Wynn M, Kesler K, Morellato J, Higginbotham R, Robertson M, Marsh JL, Hogue M. J. Orthop. Trauma 2021; ePub(ePub): ePub. |
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Abstract
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OBJECTIVE: To compare deep infection rate and causative organisms in open fractures of the lower extremity from agricultural trauma to similar injuries in non-agricultural trauma.
DESIGN: Retrospective. SETTING: Two tertiary-care institutions.
METHODS: Open lower extremity fractures sustained between 2003-2018 by agriculture-related trauma in adult patients were reviewed. A non-agriculture open fracture control group was identified for comparison. Patient demographics and injury characteristics were assessed. Outcomes included occurrence of deep infection and causative organism.
RESULTS: 178 patients were identified in the agriculture(AG) (n=89) and control(NAG) (n=89) groups. Among agricultural-injury patients, farm machinery was the most common mechanism in 69 (77.5%) patients. Open injuries of the foot (38.2%) were most common in the AG-group and tibial shaft (25.8%) in the NAG-group.Deep infection was seen in 21% of the AG-group compared to 10% in the NAG-group(p<0.05). AG-group anaerobic infection occurred in 44% of patients with deep infection versus 9.1% in NAG-group(p<0.05). Most common anaerobic organisms included Enterococcus, Pseudomonas aeruginosa, and Clostridium perfringens.
CONCLUSION: This study supports that open fractures due to agricultural trauma have a high infection rate, with anaerobic infection occurring at higher rates than in non-agricultural trauma. Prophylactic treatment with antibiotics directed against anaerobes is indicated in these injuries. LEVEL OF EVIDENCE: Diagnostic Level III. See Instructions for Authors for a complete description of levels of evidence.
Language: en |