title: The Gustilo-Anderson classification system as predictor of nonunion and infection in open tibia fractures.
abstract: OBJECTIVE
  We sought to conduct the largest retrospective study to date of open tibia fractures and describe the incidence of complications and evaluate the potential predictive risk factors for complications.
  
  
  METHODS
  Patients with open tibia fractures treated with reamed intramedullary nail (IMN) across a 10-year period were evaluated. Patient charts were reviewed for demographics, type of open fracture (T), comorbidities, and postoperative complications. A multivariate model was conducted to determine the risk factors for each type of complication.
  
  
  RESULTS
  Of the 486 patients with open tibia fractures, 13 % (n = 64) had infections, 12 % (n = 56) had nonunions, and 1 % (n = 7) had amputations. TIII fractures had much higher rates of each complication than TI and TII fractures. Fracture type was the only significant risk factor for both nonunion and infection.
  
  
  CONCLUSIONS
  Our study found that the Gustilo grade of open tibia fracture is by far the greatest predictor of nonunion and infection.
authors.affiliation: The Vanderbilt Orthopaedic Institute Center for Health Policy, Vanderbilt University, Suite 4200, South Tower, MCE, Nashville, TN, 37221, USA.
authors.forename: R V
authors.initials: RV
authors.lastname: Thakore
authors.affiliation: The Vanderbilt Orthopaedic Institute Center for Health Policy, Vanderbilt University, Suite 4200, South Tower, MCE, Nashville, TN, 37221, USA.
authors.forename: E L
authors.initials: EL
authors.lastname: Francois
authors.affiliation: The Vanderbilt Orthopaedic Institute Center for Health Policy, Vanderbilt University, Suite 4200, South Tower, MCE, Nashville, TN, 37221, USA.
authors.forename: S K
authors.initials: SK
authors.lastname: Nwosu
authors.affiliation: The Vanderbilt Orthopaedic Institute Center for Health Policy, Vanderbilt University, Suite 4200, South Tower, MCE, Nashville, TN, 37221, USA.
authors.forename: B
authors.initials: B
authors.lastname: Attum
authors.affiliation: Department of Orthopaedics and Rehabilitation, University of Wisconsin Hospital and Clinics, 1685 Highland Ave., Madison, WI, 53705, USA.
authors.forename: P S
authors.initials: PS
authors.lastname: Whiting
authors.affiliation: The Vanderbilt Orthopaedic Institute Center for Health Policy, Vanderbilt University, Suite 4200, South Tower, MCE, Nashville, TN, 37221, USA.
authors.forename: M A
authors.initials: MA
authors.lastname: Siuta
authors.affiliation: The Vanderbilt Orthopaedic Institute Center for Health Policy, Vanderbilt University, Suite 4200, South Tower, MCE, Nashville, TN, 37221, USA.
authors.forename: M A
authors.initials: MA
authors.lastname: Benvenuti
authors.affiliation: The Vanderbilt Orthopaedic Institute Center for Health Policy, Vanderbilt University, Suite 4200, South Tower, MCE, Nashville, TN, 37221, USA.
authors.forename: A K
authors.initials: AK
authors.lastname: Smith
authors.affiliation: The Vanderbilt Orthopaedic Institute Center for Health Policy, Vanderbilt University, Suite 4200, South Tower, MCE, Nashville, TN, 37221, USA.
authors.forename: M S
authors.initials: MS
authors.lastname: Shen
authors.affiliation: The Vanderbilt Orthopaedic Institute Center for Health Policy, Vanderbilt University, Suite 4200, South Tower, MCE, Nashville, TN, 37221, USA.
authors.forename: I
authors.initials: I
authors.lastname: Mousavi
authors.affiliation: The Vanderbilt Orthopaedic Institute Center for Health Policy, Vanderbilt University, Suite 4200, South Tower, MCE, Nashville, TN, 37221, USA.
authors.forename: W T
authors.initials: WT
authors.lastname: Obremskey
authors.affiliation: The Vanderbilt Orthopaedic Institute Center for Health Policy, Vanderbilt University, Suite 4200, South Tower, MCE, Nashville, TN, 37221, USA. manish.sethi@vanderbilt.edu.
authors.forename: M K
authors.initials: MK
authors.lastname: Sethi
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016208:Databases, Factual; D005260:Female; D005594:Fracture Fixation, Intramedullary; D017102:Fracture Healing; D005599:Fractures, Ununited / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D006801:Humans; D015994:Incidence; D015601:Injury Severity Score; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D012307:Risk Factors; D013530:Surgical Wound Infection / Q000453:epidemiology; D013978:Tibial Fractures / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D014481:United States / Q000453:epidemiology; D055815:Young Adult
keywords: Infection; Orthopedics; Tibia fractures