Infectious complications of open leg fractures

Open leg fractures account for 5 to 10% of all fractures. They are prone to numerous complications, particularly infection. Their emergency management is medical and surgical. We conducted a prospective cohort study of patients with open leg fractures over a 6-month period from 17 May to 30 September 2015. Fifty-seven patients were included in the study. The infection rate was 19.3% (11 cases). Gustilo type III fractures (RR = 13.75) and externalization of the bone (RR = 3.52) were identified as infectious risk factors. A very high C-Reactive Protein level of more than 100 mg/l in the first week predicted the occurrence of an infection. Pseudomonas predominated (33.33%), followed by Staphylococcus aureus (20%). Multidrug resistant bacteria had a high proportion (40%). Sensitivity to Gentamycin and third generation Cephalosporins was good. In conclusion, apart from bone stabilisation, surgical debridement combined with antibiotic prophylaxis is essential to minimise the risk.

Autorentext

Born on 10 November 1991 in Tsidjé-Itsandra, primary school of Tsidjé, Royal College of the Comoros (high school and college), Faculty of Medicine of Tananarive. Doctor: Medical and surgical centre of Mbéni (Comoros).