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2021, Number 2

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Revista Cubana de Ortopedia y Traumatología 2021; 35 (2)

Management of open tibial fractures in cuba

MacKechnie MC, Albright PD, Tabares SH, Tabares NH, Materno PY, Pancorbo SE, Urbay CF, Acosta ML, Gutiérrez BMO, Jerez LJ, Martínez MA, Miclau T, Alvarez BO, Amigo CP, Artiles GDA, Díaz QJM, Falcón AJ, Gutiérrez HR, López BR, Mata CR, Morales PSV, Sánchez CR, Tusell MO

Language: Spanish
References: 37
Page: 1-21
PDF size: 677.42 Kb.


ABSTRACT

Introduction: Open tibial fractures are a subset of the trauma burden in Latin America. Questions related to treatment, potentially critical in Cuba, a country with limited resources, but with standardized national health program, coherence in education, and similarities of graduate programs were examined.
Objective: To describe the treatment patterns of open tibial fracture in Cuba, and to compare the characteristics of acute and late management in seven provinces of the country.
Methods: Sixty seven orthopedic surgeons were surveyed to evaluate four aspects of open fracture management, regarding antibiotic prophylaxis, irrigation and debridement, stabilization, and wound management. The convenience sampling method was used to identify surgeons and the analysis was performed using Fisher's exact test (p <0.05).
Results: Postoperative antibiotics were administered for more than 72 hours for GA-I / II fractures (49%) and GA-III fractures (70%). Surgeons in Havana (n = 32) used primary internal fixation for GA-I / II fractures more frequently than surgeons in the remaining provinces (n = 35) (64.3% vs. 30.3%, p = 0.008). Surgeons from other provinces performed primary closure at the time of definitive fixation of GA-I / II fractures more frequently than those from Havana (62.9% vs. 32.3%, p = 0.013). For GA-III fractures, the majority of Havana surgeons (88.6%), as well as those of the remaining provinces (96.8%) preferred to perform deferred closure.
Conclusions: The treatment of open tibial fractures in Cuba is generally consistent with other Latin American countries. The characteristics of the management of open tibial fractures in Cuba are described and differences in wound stabilization and treatment methods between provinces are compared, which is useful to assess whether they are the result of differences in surgical practice, or in availability of resources. This is helpful in addressing ways to optimize patient care through specialized training and resource allocation.


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