title: Potential predictive ability of the orthopaedic trauma association open fracture classification.
abstract: OBJECTIVE
  Is the OTA open fracture classification (OTA-OFC) potentially predictive of early amputation and specific clinical treatments?
  
  
  METHODS
  Retrospective chart review of prospectively collected data.
  
  
  METHODS
  Level I trauma center, Seattle, WA.
  
  
  METHODS
  Three hundred fifty-six patients with open fractures of the femur, tibia, malleoli, humerus, radius/ulna, pelvis, acetabulum, foot, or clavicle.
  
  
  METHODS
  No intervention.
  
  
  METHODS
  Vacuum-assisted closure placement, 3+ irrigation and debridements, antibiotic bead placement, and early amputation.
  
  
  RESULTS
  The OTA-OFC is related to the type of treatment used to treat an open fracture. The model demonstrated that the strongest potential predictor of vacuum-assisted closure use is the severity of the skin injury; multiple debridements (≥ 2) is best predicted by the severity of the skin injury and muscle injury; bone loss was the strongest potential predictor of antibiotic bead placement; and the strongest predictors of early amputation are skin injury, contamination, and arterial injury.
  
  
  CONCLUSIONS
  Exploratory analysis of these data demonstrates that variations in muscle damage, skin injury, bone loss, arterial injury, and contamination sustained in an open fracture are related to different treatments in the total study population and for anatomical regions. The information provided by this study demonstrates that the OTA-OFC may have predictive abilities relative to how an open fracture is treated.
  
  
  METHODS
  Prognostic level II. See Instructions for Authors for a complete description of levels of evidence.
authors.affiliation: *Department of Orthopaedic Surgery and Sports Medicine, Harborview Medical Center, Seattle, WA; †Division of Health Policy and Management, University of Minnesota, Minneapolis, MN; ‡Christus Spohn Memorial Hospital, Corpus Christi, TX; and §Department of Orthopaedic Surgery, University of Iowa Hospitals and Clinics, Iowa City, IA.
authors.forename: Julie
authors.initials: J
authors.lastname: Agel
authors.forename: Todd
authors.initials: T
authors.lastname: Rockwood
authors.forename: Richard
authors.initials: R
authors.lastname: Barber
authors.forename: J Lawrence
authors.initials: JL
authors.lastname: Marsh
mesh_terms: D000671:Amputation, Surgical; D000900:Anti-Bacterial Agents / Q000008:administration & dosage; D003646:Debridement; D005597:Fractures, Open / Q000145:classification* / Q000188:drug therapy / Q000601:surgery*; D006801:Humans; D054843:Negative-Pressure Wound Therapy; D011379:Prognosis; D012189:Retrospective Studies
chemical_list: D000900:Anti-Bacterial Agents