A Study of Immediate and Delayed Closure of Type II and IIIa Open Tibia Fractures

A Randomized Study of Immediate and Delayed Closure of Type II and IIIa Open Tibia Fractures: A Pilot Study

Delayed wound closure is considered by many to be the standard of care for the treatment of an open fracture. This study was conducted to determine the feasibility of a large multi-center prospective randomized clinical trial and collect the pilot data needed to compete for the funding for such a trial. The study was designed to compare immediate and delayed closure of Gustilo type II and IIIa tibia diaphyseal fractures. The primary outcomes were the infection rates and fracture related complications in patients treated with immediate or delayed wound closure strategies.

Inclusion Criteria:

• Gustilo type II-IIIa tibia fracture
• age greater than 15 years
• fractures amenable to intramedullary nailing

Exclusion Criteria:

• excessive wound contamination
• patient cardio-pulmonary or hemodynamic instability preventing prompt surgical intervention
• impaired or absent consciousness
• refusal of consent