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Minerva Ortopedica e Traumatologica 2018 December;69(4):112-6

DOI: 10.23736/S0394-3410.18.03895-X


lingua: Inglese

Fever after open femur fracture: is it prognostic for infection?

Alessandro APRATO , Umberto VISENTIN, Federico BERTOLO, Andrea CONTI, Luigi CONFORTI, Alessandro MASSÈ

Department of Orthopedics and Traumatology, CTO Hospital, University of Turin, Turin, Italy

BACKGROUND: The relationship between post-traumatic fever after open femur fracture and subsequent infection is not clear. Fever in the first days after injury may be due to hematoma reabsorption or to an initial local infection. Aim of this study is to correlate fever in the first 15 days after an open femoral shaft fracture and local infection before bone healing.
METHODS: A retrospective search of our databases was conducted. Patients with open femur fracture admitted at our emergency room between January 2000 and September 2015 were considered. Seventy-one patients were collected for the study; each patient underwent early surgical treatment with external fixation within 6 hours from the admission, with an intravenous prophylactic antibiotic therapy 5 days long. For each patient were investigated the presence of soft tissue lesions, fracture patterns, injury Severity Score (ISS), length of hospitalization, complications occurred at fracture site (such as osteomyelitis). All these variables were compared with the presence of fever during the first 15 days after injury.
RESULTS: Fever was detected in 45 patients (76.3%) of our series, but did not significantly correlate with the development of osteomyelitis (χ2=0.1841; P=0.668). Higher Gustilo grades corresponded to higher incidence of osteomyelitis (χ2=12.6; P=0.013). Although there was no significant correlation between microbial agents detected from the swab test before first surgery or during the first hospital stay and development of osteomyelitis (χ2=0.0724; P=0.788).
CONCLUSIONS: Fever itself does not correlate with development of bone infection in open femoral fractures.

KEY WORDS: Fever - Open fractures - Femoral fractures - Infection

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